Neuromyelitis optica spectrum disorders associated with other autoimmune diseases

Abstract

Neuromyelitis optica (NMO) is an inflammatory demyelinating autoimmune disease with severe, tremendously incapacitating, consequences in the patient's health and wellbeing. Until 2004, NMO was considered a restricted type of multiple sclerosis but in the same year an auto-antibody reacting against aquaporin-4 (NMO-IgG) was found to be related with NMO and it was considered the main etiologic agent of this disease. Its detection is very sensitive and specific allowing an early diagnosis and a better treatment and prognosis. With this tool, a spectrum of diseases including other autoimmune diseases was found to have NMO-IgG antibodies and a new classification named NMO spectrum disorders was created. In this review, we sum up the developments in this field associated with other autoimmune diseases. We approach the latest discoveries in the diagnosis like the new biomarkers that will possibly be used in the close future or the developments in the neuroimaging techniques. We reviewed the literature and synthesized case reports of NMO patients with concurrent autoimmune diseases and the information from useful larger studies. Finally, we summarize the commonly used treatments in NMO and we try to specify the best treatment for NMO with simultaneous autoimmune disease. This review updates the information about this issue and raises the awareness of rheumatologists for these severe diseases.

Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica

“…Although 3 patients had a spinal cord lesion that involved fewer than 3 vertebral segments, they fulfilled the other 2 supportive criteria (NMO-IgG ϩ and brain MR imaging that did not meet the diagnostic criteria for multiple sclerosis). Consistent with previous studies reporting the presence of other autoimmune diseases in a subset of patients with NMO, 30,31 6 of the patients with NMO in this study presented with autoimmune diseases. Although they fulfilled the diagnostic criteria for NMO, we cannot exclude the effects of comorbidities on the intergroup GMV differences.…”

Epidemiological, clinical, and immunological characteristics of neuromyelitis optica: A review

“…There is [24][25][26][27][28][29][30][31]. In many cases, NMO is frequently associated with multiple other autoantibodies, including specific antibodies against for a panel of extracellular and intracellular antigens, such as antinuclear antibodies (ANA), antibodies against double-stranded DNA (anti-dsDNA), extractable nuclear antigen (anti-ENA), tireoperoxidase (anti-TPO), tireoglobulin (anti-Tg), acetylcholine receptor (AChR-Ab), and celiac disease-related antibodies, such as deamidated gliadin and tissue transglutaminase antibodies.…”

“…It is also responsible for glutamate and potassium regulation in the blood-brain barrier, synapses, and paranodes adjacent to the nodes of Ranvier. AQP4 is a transmembrane protein expressed in the feet expansions of the astrocytes and regulates water movement between blood, brain, and CSF [30,[74][75][76].…”

Aquaporin-4 positive neuromyelitis optica spectrum disorders secondary to thrombopenic purpura

“…[5] Although the mechanism remains unrevealed, approximately 25% of all NMOSD patients have other concomitant autoimmune disorders. [6,7] Nevertheless, the overlap of NMOSD and thrombopenic purpura has scarcely been reported.…”