Cerebrospinal fluid findings in aquaporin-4 antibody positive neuromyelitis optica: Results from 211 lumbar punctures

Jarius, Sven; Paul, Friedemann; Franciotta, Diego; Ruprecht, Klemens; Ringelstein, Marius; Bergamaschi, Roberto; Rommer, Paulus; Kleiter, Ingo; Stich, Oliver; Reuß, Reinhard; Rauer, Sebastian; Zettl, Uwe K.; Wandinger, Klaus Peter; Melms, Arthur; Aktaş, Orhan; Kristoferitsch, Wolfgang; Wildemann, Brigitte

doi:10.1016/j.jns.2011.03.038

Cited by 309 publications

(269 citation statements)

References 47 publications

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“…Frequently, differential cell analysis demonstrates neutrophils, eosinophils, activated lymphocytes, and/or plasma cells. Albumin CSF/serum ratios, total protein and CSF L-lactate levels correlated significantly with disease activity as well as with the length of the spinal cord lesions in patients with acute myelitis 30 . Total CSF protein level is increased between 290 to 640 mg/dl during relapse and between 33 to 63 mg/dl at the remission phase.…”

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confidence: 89%

“…Total CSF protein level is increased between 290 to 640 mg/dl during relapse and between 33 to 63 mg/dl at the remission phase. Additionally, CSF findings differed significantly between patients with acute myelitis and patients with acute optic neuritis at the time of LP 20,30 .…”

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confidence: 94%

“…CSF-restricted oligoclonal IgG bands, a hallmark of MS, are absent in most NMO patients, with the studies demonstrating around 15-30% of detection rate 9,30 . If present, intrathecal IgG (and, more rarely, IgM) synthesis is low, transient, and, importantly, restricted to acute relapses.…”

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confidence: 99%

“…If present, intrathecal IgG (and, more rarely, IgM) synthesis is low, transient, and, importantly, restricted to acute relapses. In addition, QAlb may be elevated both during relapse and during remission, indicating sustained blood CSF barrier dysfunction andsubclinical disease activityin patients with AQP4-Ab posi tive NMOSD CSF pleocytosis is present in around 50% of samples, with cell counts varying between 28 to 57 cells/mm 3 , sometimes reaching 2,000 cells/mm 320,30 . Frequently, differential cell analysis demonstrates neutrophils, eosinophils, activated lymphocytes, and/or plasma cells.…”

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confidence: 99%

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Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Matas

Glehn

Fernandes³

et al. 2013

Arq. Neuro-Psiquiatr.

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The central nervous system demyelinating diseases are a group of disorders with different etiologies, characterized by inflammatory lesions that are associated with loss of myelin and eventually axonal damage. In this group the most studied ones are multiple sclerosis (MS), neuromyelitis optic (NMO) and acute disseminated encephalomyelitis (ADEM). The cerebrospinal fluid is essential to differentiate between these different syndromes and to define multiple sclerosis, helping to assess the probability of Clinical Isolated Syndrome turn into multiple sclerosis.

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confidence: 89%

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confidence: 94%

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confidence: 99%

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confidence: 99%

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Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Matas

Glehn

Fernandes³

et al. 2013

Arq. Neuro-Psiquiatr.

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“…67 The type 2 OCB pattern, in which OCBs are found in the CSF but not in the serum, indicating isolated intrathecal oligoclonal IgG synthesis, is only found in about 10% of patients with NMO. 68,69 However, CSF glial fibrillary acidic protein (GFAP) levels have a high sensitivity (85-100%) but low specificity (77-100%) for acute NMO.…”

Section: Immunological Pathologymentioning

confidence: 99%

The investigation of acute optic neuritis: a review and proposed protocol

et al. 2014

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| Optic neuritis is an inflammatory optic neuropathy that affects many patients with multiple sclerosis (MS) at some point during their disease course. Differentiation of acute episodes of MS-associated optic neuritis from other autoimmune and inflammatory optic neuropathies is vital for treatment choice and further patient management, but is not always straightforward. Over the past decade, a number of new imaging, laboratory and electrophysiological techniques have entered the clinical arena. To date, however, no consensus guidelines have been devised to specify how and when these techniques can be most rationally applied for the diagnostic work-up of patients with acute optic neuritis. In this article, we review the literature and attempt to formulate a consensus for the investigation of patients with acute optic neuritis, both in standard care and in research with relevance to clinical treatment trials.

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