Clinical and MRI features of Japanese patients with multiple sclerosis positive for NMO-IgG

Abstract

This study investigates the relation between the serological status of NMO (neuromyelitis optica)-IgG and the clinical and MRI features in Japanese patients with multiple sclerosis. Serum NMO-IgG was tested in 35 Japanese patients diagnosed with multiple sclerosis, including 19 with the optic-spinal form of multiple sclerosis (OSMS), three with the spinal form of multiple sclerosis (SMS), and 13 with the conventional form of multiple sclerosis (CMS), which affects the brain. NMO-IgG was detected in 14 patients, 12 with OSMS and 2 with CMS. In these patients, longitudinally extensive (> 3 vertebral segments) spinal cord lesions (93% v 57%) and permanent, complete blindness (no perception of light) in at least one eye (50% v 0%) were the noticeable features as compared with NMO-IgG-negative OSMS. The two patients having CMS with NMO-IgG had unusual brain lesions, but in other respects had features suggesting OSMS. NMO-IgG was detected in more than half the number of patients with OSMS and in some patients with CMS. This newly discovered serum autoantibody was markedly associated with longitudinally extensive spinal cord lesions and with complete blindness, suggesting severe optic-spinal disease.

Seroprevalence of NMO-IgG antibody in Brazilian patients with neuromyelitis optica

“…In our series, among clinically defined NMO patients, NMO-IgG was positive in 64.3%. This seroprevalence is similar to that observed by others 3,8 .…”

“…In that seminal paper the authors found sensitivity and specificity for NMO diagnosis of 73% and 91%, respectively 3 . In Japan, authors detected NMOIgG in more than half of OSMS patients (63% sensitivity) 8 , suggesting that NMO and OSMS could be the same entity.…”

“…Demographic and clinical characteristics of patients included in our study are shown on Table 1. Briefly, median age at onset of disease was 27 years (range 7-51), median time of follow-up was 8 years (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The mean time elapsed between optic neuritis and myelitis was 18 months (median 21; range 2-60), Kurtzke's Expanded Disease Severity Score on last visit was 6.0 (range 2-8).…”

Seropositive Neuromyelitis Optica (Devic’s Disease): A Rare Case Report

“…A radiological feature of NMO is a longitudinally extensive cord lesion, often extending over three or more spinal segments, but MS involves fewer than two spinal segments. 7,8 In our Patient MRI of cervical and thoracic spine revealed a longitudinal area of hyperintensity and spinal cord thickening from C3-T1 in T2-weighted image which is consistent with the radiographic diagnostic criteria for NMO.…”

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] . These discrepancies may be accounted for by patient selection (NMO versus OSMS patients; different populations) and false-negative findings because of the low sensitivity of the assay.…”