Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Brain Behav. 2018 Nov;8(11):e01129. doi: 10.1002/brb3.1129. Epub 2018 Oct 3.
Neuromyelitis optica (NMO) is frequently associated with aquaporin-4 autoantibodies (AQP4-Ab); however, studies of NMO in Lithuania are lacking. Therefore, the main objective of our study is to assess positivity for AQP4-Ab in patients presenting with inflammatory demyelinating central nervous system (CNS) diseases other than typical multiple sclerosis (MS) in Lithuania.
Data were collected from the two largest University hospitals in Lithuania. During the study period, there were 121 newly diagnosed typical MS cases, which were included in the MS registry database. After excluding these typical MS cases, we analyzed the remaining 29 cases of other CNS inflammatory demyelinating diseases, including atypical MS (n = 14), acute transverse myelitis, TM (n = 8), acute disseminated encephalomyelitis, ADEM (n = 3), clinically isolated syndrome, CIS (n = 2), atypical optic neuritis, ON (n = 1), and NMO (n = 1). We assessed positivity for AQP4-Ab for the 29 patients and evaluated clinical, laboratory, and instrumental differences between AQP4-Ab seropositive and AQP4-Ab seronegative patient groups.
AQP4-Ab test was positive for three (10.3%) patients in our study, with initial diagnoses of atypical MS (n = 2) and ADEM (n = 1). One study patient was AQP4-Ab negative despite being previously clinically diagnosed with NMO. There were no significant clinical, laboratory, or instrumental differences between the groups of AQP4-Ab positive (3 [10.3%]) and negative (26 [89.7%]) patients.
AQP4-Ab test was positive for one-tenth of patients with CNS inflammatory demyelinating diseases other than typical MS in our study. AQP4-Ab testing is highly recommended for patients presenting with not only TM and ON but also an atypical course of MS and ADEM.
视神经脊髓炎（NMO）常与水通道蛋白-4 自身抗体（AQP4-Ab）相关；然而，立陶宛缺乏关于 NMO 的研究。因此，我们研究的主要目的是评估在立陶宛，除了典型多发性硬化症（MS）之外，患有其他中枢神经系统（CNS）炎症性脱髓鞘疾病的患者中 AQP4-Ab 的阳性率。
数据来自立陶宛的两家最大的大学医院。在研究期间，有 121 例新诊断的典型 MS 病例，这些病例被纳入 MS 登记数据库。排除这些典型 MS 病例后，我们分析了其余 29 例其他 CNS 炎症性脱髓鞘疾病病例，包括非典型 MS（n=14）、急性横贯性脊髓炎（TM）（n=8）、急性播散性脑脊髓炎（ADEM）（n=3）、临床孤立综合征（CIS）（n=2）、非典型视神经炎（ON）（n=1）和 NMO（n=1）。我们评估了 29 例患者的 AQP4-Ab 阳性率，并评估了 AQP4-Ab 阳性和 AQP4-Ab 阴性患者组之间的临床、实验室和仪器差异。
我们的研究中有 3 例（10.3%）患者的 AQP4-Ab 检测呈阳性，最初诊断为非典型 MS（n=2）和 ADEM（n=1）。1 名研究患者尽管之前被临床诊断为 NMO，但 AQP4-Ab 检测呈阴性。AQP4-Ab 阳性（3[10.3%]）和阴性（26[89.7%]）患者组之间没有显著的临床、实验室或仪器差异。
我们的研究中，除了典型 MS 之外，其他 CNS 炎症性脱髓鞘疾病患者中有十分之一的 AQP4-Ab 检测呈阳性。AQP4-Ab 检测强烈建议用于不仅患有 TM 和 ON，而且还患有非典型 MS 和 ADEM 患者。
