Department of Neurology, V.S. General Hospital, Ahmedabad, Gujarat, India.
Neurol India. 2022 May-Jun;70(3):1131-1136. doi: 10.4103/0028-3886.349679.
Neuromyelitis optica (NMO) is a central demyelinating disorder, predominantly affecting the optic nerves and spinal cord and autoimmune basis. We aimed to analyze the clinical, laboratory, and imaging features associated with NMO spectrum disorders (NMOSD) according to the aquaporin 4 antibody (AQP4-Ab) serology status.
The inclusion of the patients was based on the Wingerchuk criteria (2006) for NMO, known antibody status and has minimum 1-year follow-up. We analyzed and compared 46 patients with known antibody status.
AQP4-Ab positivity was 56.5%. The male to female ratio in the seropositive group was 1:7.7 and 1:1.2 in the seronegative group. The mean age of onset in seropositive patients was 36.8 years (vs 28.8 years in seronegative NMOSD patients). Clinical feature, cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) features were also different, but data from two subsets did not reach statistical significance. The relapse rate was higher in AQP4 positive NMOSD (84.6% vs 55% in the seronegative group). The recovery rate for AQP4 positive patients was poor (15%).
We found differences in age, gender, and prognosis between the two groups. Antibody status may be a guiding factor in deciding the treatment approach during the first attack of NMOSD.
视神经脊髓炎（NMO）是一种主要影响视神经和脊髓的中枢脱髓鞘疾病，具有自身免疫基础。我们旨在根据水通道蛋白 4 抗体（AQP4-Ab）血清学状态分析与 NMO 谱障碍（NMOSD）相关的临床、实验室和影像学特征。
根据 Wingerchuk 标准（2006 年）纳入 NMO 患者、已知的抗体状态和至少 1 年的随访。我们分析并比较了 46 名具有已知抗体状态的患者。
AQP4-Ab 阳性率为 56.5%。在阳性组中，男女比例为 1:7.7，在阴性组中为 1:1.2。阳性组患者的发病年龄平均为 36.8 岁（阴性 NMOSD 患者为 28.8 岁）。临床特征、脑脊液（CSF）和磁共振成像（MRI）特征也不同，但两组数据未达到统计学意义。AQP4 阳性 NMOSD 的复发率较高（84.6% vs 阴性组的 55%）。AQP4 阳性患者的恢复率较差（15%）。
我们发现两组之间在年龄、性别和预后方面存在差异。抗体状态可能是决定 NMOSD 首次发作时治疗方法的一个指导因素。
