Aquaporin-4 antibody positive longitudinally extensive transverse myelitis following varicella zoster infection

Neuromyelitis optica (NMO) has been traditionally described as the association of recurrent or bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM). Identification of aquaporin-4 antibody (AQP4-IgG) has deeply changed the concept of NMO. A spectrum of NMO disorders (NMOSD) has been formulated comprising conditions which include both AQP4-IgG seropositivity and one of the index events of the disease (recurrent or bilateral optic neuritis and LETM). Most NMO patients harbor asymptomatic brain MRI lesions, some of them considered as typical of NMO. Some patients with aquaporin-4 autoimmunity present brainstem, hypothalamic or encephalopathy symptoms either preceding an index event or occurring isolatedly with no evidence of optic nerve or spinal involvement. On the opposite way, other patients have optic neuritis or LETM in association with typical lesions of NMO on brain MRI and yet are AQP4-IgG seronegative. An expanded spectrum of NMO disorders is proposed to include these cases.

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Longitudinally Extensive Transverse Myelitis with Aquaporin-4 Antibody Positivity in Renal Cell Carcinoma: Rare Occurrence

Neurology India ◽

10.4103/0028-3886.266293 ◽

2019 ◽

Vol 67 (4) ◽

pp. 1087 ◽

Cited By ~ 1

Author(s):

RohanR Mahale ◽

Anish Mehta ◽

Kiran Buddaraju ◽

Mahendra Javali ◽

AbhinandanK Shankar ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Transverse Myelitis ◽

Aquaporin 4 ◽

Rare Occurrence ◽

Longitudinally Extensive Transverse Myelitis ◽

Antibody Positivity ◽

Aquaporin 4 Antibody ◽

Extensive Transverse Myelitis

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Antibodies to myelin oligodendrocyte glycoprotein in aquaporin 4 antibody seronegative longitudinally extensive transverse myelitis: Clinical and prognostic implications

Multiple Sclerosis Journal ◽

10.1177/1352458515591071 ◽

2015 ◽

Vol 22 (3) ◽

pp. 312-319 ◽

Cited By ~ 45

Author(s):

Álvaro Cobo-Calvo ◽

María Sepúlveda ◽

Raphael Bernard-Valnet ◽

Anne Ruiz ◽

David Brassat ◽

...

Keyword(s):

Optic Neuritis ◽

Transverse Myelitis ◽

Myelin Oligodendrocyte Glycoprotein ◽

Aquaporin 4 ◽

First Episode ◽

Longitudinally Extensive Transverse Myelitis ◽

Increase Risk ◽

Cerebrospinal Fluid Pleocytosis ◽

Aquaporin 4 Antibody ◽

Extensive Transverse Myelitis

Objective: We aimed to investigate the frequency and clinical significance of antibodies to myelin oligodendrocyte glycoprotein (MOG-abs) in patients who presented with a first episode of seronegative aquaporin 4 antibody (AQP4-ab) longitudinally extensive transverse myelitis (LETM). Methods: Epidemiological, clinical, and paraclinical data of 56 patients from three European centres were analysed. Patients were retrospectively tested for MOG-abs and AQP4-abs, by cell-based assays. Findings: Thirteen (23.2%) patients were MOG-ab positive. Among the 56 patients, six (10.7%) converted to neuromyelitis optica (NMO), one (1.8%) to multiple sclerosis (MS), nine (16.1%) had recurrent LETM, and 40 (71.4%) remained as monophasic LETM. Compared with seronegative patients, those with MOG-abs were younger (median: 32.5 vs 44 years; p=0.007), had cerebrospinal fluid pleocytosis more frequently (94% vs 45%, p=0.003) and had better outcome (median Expanded Disability Status Scale (EDSS) 2.0 vs 3.0, p=0.027). MOG-ab positive patients also showed an increase risk of optic neuritis relapse and NMO conversion ( p=0.010). Conclusion: Patients with MOG-abs in AQP4-ab seronegative LETM have clinical distinctive features, higher risk of optic neuritis relapses, and better outcome than patients seronegative.

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