Acute transverse myelitis in demyelinating diseases among the Chinese

Abstract

The aim of the study was to characterize the demographic, clinical, and prognostic features of Chinese patients with acute transverse myelitis (ATM). The clinical data from ATM patients in a demyelinating disease database were analyzed retrospectively. Sixty-seven ATM patients with a follow-up duration longer than 2 years were identified. The frequency of neuromyelitis optica-related ATM (NMO-ATM) was high in our cohort (40.3%). Recurrent ATM (R-ATM), with a female predominance, was common in total idiopathic ATM (69.0%, 20/29). In R-ATM with longitudinally extensive spinal cord lesions (LESCLs), the high seropositivity of NMO-IgG, spinal cord lesions mostly involved the central gray matter and severer long-term disability were similar to NMO-ATM. In RTM without LESCLs, low seropositivity of NMO-IgG, preferentially involvement of the peripheral white matter and relative better neurological recovery were consistent with multiple sclerosis-related ATM (MS-ATM). The transition rates to MS in patients with acute partial transverse myelitis (APTM) and acute complete transverse myelitis (ACTM) were not significant (16.7 vs. 6.3%, P = 0.753), while LESCLs (OR = 11.4, P = 0.028) were significantly correlated with transition to NMO. The presence of LESCLs was the only variable showing a higher risk for reaching Rankin 3 (hazard ratio: 2.5, 95% CI: 1.0-6.1). Chinese patients with ATM had demographic, clinical, and prognostic features different from those in Western populations. Idiopathic R-ATM, common in Chinese, is a heterogeneous entity that shares partial clinical, spinal MRI and prognostic features with MS-ATM and NMO-ATM. The length of spinal cord lesion, rather than APTM/ACTM, may be a prognostic factor associated with clinical outcome and long-term disability in our population.

Serum-Positive and -Negative AQP4 Antibody NMO in Chinese Patients

“…In a French study, Marignier and colleagues reported that there was no difference between NMOIgG sero-positive and sero-negative NMO patients according to their clinical, CSF, and imaging features 14 . However, in the Japanese, AQP4 antibody-positive NMO/OSMS patients had a greater frequency of longitudinally extensive spinal cord or brain lesions than did anti-AQP4 antibody-negative NMO/OSMS patients 9,[15][16][17] .…”

Serum Thyroid-Stimulating Hormone and Anti-Thyroglobulin Antibody Are Independently Associated with Lesions in Spinal Cord in Central Nervous System Demyelinating Diseases

“…Transverse myelitis (TM) is an inflammatory demyelinating disorder of the spinal cord that has various manifestations [1]. TM has several subtypes according to origin but in China the most common are neuromyelitis optica (NMO) spectrum and multiple sclerosis (MS) [1].…”

“…TM has several subtypes according to origin but in China the most common are neuromyelitis optica (NMO) spectrum and multiple sclerosis (MS) [1].…”

Neuromyelitis Optica Spectrum Disorder and Neurosyphilis Coexist in A Chinese Woman

“…TM has several subtypes according to origin but, in China, most of them are associated with neuromyelitisoptica (NMO) and multiple sclerosis (MS) [1]. However, the exact etiologies of inflammatory demyelinating TM are unclear and the details of their pathogenesis are unknown.…”

“…Transverse myelitis (TM) is an inflammatory demyelinating disorder of the spinal cord that has various manifestations [1]. TM has several subtypes according to origin but, in China, most of them are associated with neuromyelitisoptica (NMO) and multiple sclerosis (MS) [1].…”