scholarly journals The Prevalence of Anti-Aquaporin 4 Antibody in Patients with Idiopathic Inflammatory Demyelinating Diseases Presented to a Tertiary Hospital in Malaysia: Presentation and Prognosis

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
S. Abdullah ◽  
W. F. Wong ◽  
C. T. Tan
Keyword(s):  
Spinal Cord ◽  
Transverse Myelitis ◽  
Tertiary Hospital ◽  
Demyelinating Diseases ◽  
Aquaporin 4 ◽  
Spinal Cord Lesions ◽  
Clinical Presentations ◽  
Disability Status ◽  
Aquaporin 4 Antibody ◽  
Aqp4 Antibody

Background. There have been inconsistent reports on the prevalence and pathogenicity of anti-Aquaporin 4 (AQP4) in patients presented with idiopathic inflammatory demyelinating diseases (IIDDs). Objective. To estimate the prevalence of anti-AQP4 antibody in patients with IIDDs presented to University Malaya Medical Centre in terms of patients’ clinical and radiological presentations and prognoses. Methods. Retrospective data review of IIDDs patients presented from 2005 to 2015. Patients were classified into classical multiple sclerosis (CMS), opticospinal (OS) presentation, optic neuritis (ON), transverse myelitis (TM), brainstem syndrome (BS), and tumefactive MS. Anti-Aquaporin 4 antibody was tested using the Indirect Immunofluorescence Test (IIFT) cell-based assay. Statistical analysis was done using the SPSS version 20. Results. Anti-AQP4 antibody was detected in 53% of patients presented with IIDDs. CMS was more common in the seronegative group, 27/47 (57.45%; p<0.001). Conversely, OS involvement was more common in the seropositive group, 26/53 (49.06%; p<0.001). Longitudinally extensive spinal cord lesions (LESCLs) on MRI were also more common in the seropositive group, 29/40 (72.50%; p=0.004). Only 2/40 (5.00%) had MRI evidence of patchy or multiple short-segment spinal cord lesions in the AQP4-positive group (p=0.003). The relapse rate and Expanded Disability Status Scale (EDSS) were also higher in the seropositive group (5.43 versus 3.17, p=0.005; 4.07 versus 2.51, p=0.006, resp.). Typical clinical presentations that defined NMO were also seen in the seronegative patients, but in a lower frequency. Conclusion. Our cohort of patients had a higher prevalence of seropositivity of anti-AQP4 antibody as compared to those in Western countries. This was also associated with a more typical presentation of opticospinal involvement with LESCLs on MRI, a higher rate of relapse, and EDSS.

Neuropathic pruritus (itch) in neuromyelitis optica

2012 ◽  
Vol 19 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Liene Elsone ◽  
Tristan Townsend ◽  
Kerry Mutch ◽  
Kumar Das ◽  
Mike Boggild ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dorsal Horn ◽  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Aquaporin 4 ◽  
Neuropathic Pruritus ◽  
Aquaporin 4 Antibody

Background: Neuropathic pruritus (itch) is an uncommon, but well described, symptom in neurology. There are itch-specific neurons in the dorsal horn of the spinal cord. We noted excessive pruritus in patients with neuromyelitis optica (NMO). Objective: We aimed to explore the characteristics of pruritus in NMO patients. Methods: We reviewed case records of a well-defined cohort of 45 serial aquaporin-4 antibody-positive patients visiting the national NMO service. All patients were interviewed. Results: Of the 45 antibody-positive NMO patients, 44 had myelitis and 12 of those 44 (27.3%) patients reported pruritus within a week of other symptoms of transverse myelitis with central cord involvement. In three patients, pruritus was the first symptom of a relapse, while in one case, pruritus was the very first symptom of the index episode of NMO. Conclusion: Neuropathic pruritus seems to be a common, but under-recognised symptom of myelitis associated with NMO.

Contribution of spinal cord biopsy to diagnosis of aquaporin-4 antibody positive neuromyelitis optica spectrum disorder

2013 ◽  
Vol 20 (7) ◽  
pp. 882-888 ◽  
Author(s):  
M Ringelstein ◽  
I Metz ◽  
K Ruprecht ◽  
A Koch ◽  
J Rappold ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Aquaporin 4 ◽  
Diagnostic Process ◽  
Antibody Testing ◽  
Magnetic Resonance Imaging Mri ◽  
Extensive Transverse Myelitis ◽  
Aqp4 Antibody

Longitudinally extensive transverse myelitis is characteristic but not pathognomonic for neuromyelitis optica spectrum disorders (NMOSDs) and may mimic local tumors. In this retrospective study based on a cohort of 175 NMOSD patients we identified seven patients who initially presented with a longitudinally extensive spinal cord lesion and underwent spinal cord biopsy due to magnetic resonance imaging (MRI)-suspected malignancies. Remarkably, routine neuropathology was inconclusive and did not guide the diagnostic process to anti-aquaporin-4 (AQP4)-seropositive NMOSD. Serious postoperative complications occurred in 5/7 patients and persisted during follow-up in 2/7 patients (29%). Considering these sequelae, AQP4-antibody testing should be mandatory in patients with inconclusive longitudinally extensive spinal cord lesions prior to biopsy.

Cortical oscillopsia without nystagmus, an isolated symptom of neuromyelitis optica spectrum disorder with anti-aquaporin 4 antibody

2011 ◽  
Vol 18 (2) ◽  
pp. 244-247 ◽  
Author(s):  
Sung-Min Kim ◽  
Ji-Soo Kim ◽  
Young Eun Heo ◽  
Hye-Ran Yang ◽  
Kyung Seok Park
Keyword(s):  
Spinal Cord ◽  
Neuromyelitis Optica ◽  
Spectrum Disorder ◽  
Aquaporin 4 ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Ocular Manifestation ◽  
Initial Manifestation ◽  
Ocular Symptoms ◽  
Head Tremor ◽  
Aquaporin 4 Antibody

Neuromyelitis optica (NMO), mainly affecting optic nerve and spinal cord, can also manifest diverse ocular symptoms due to brain abnormalities. We present a cortical oscillopsia without nystagmus or head tremor in a patient with neuromyelitis optica spectrum disorder (NMOSD) with anti-aquaporin 4 antibody. This rare ocular manifestation, which is easily underestimated owing to absence of the typical nystagmus, can be an initial manifestation of NMOSD.

The Prevalence of Long Spinal Cord Lesions and Anti-Aquaporin 4 Antibodies in Neuromyelitis Optica Patients in Taiwan

2011 ◽  
Vol 65 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Kai-Chen Wang ◽  
Ching-Piao Tsai ◽  
Chao-Lin Lee ◽  
Shao-Yuan Chen ◽  
Shyi-Jou Chen
Keyword(s):  
Spinal Cord ◽  
Neuromyelitis Optica ◽  
Aquaporin 4 ◽  
Spinal Cord Lesions

Comparison of clinical, immunological and neuroimaging features between anti-aquaporin-4 antibody-positive and antibody-negative Sjögren’s syndrome patients with central nervous system manifestations

2012 ◽  
Vol 18 (6) ◽  
pp. 807-816 ◽  
Author(s):  
Riwanti Estiasari ◽  
Takuya Matsushita ◽  
Katsuhisa Masaki ◽  
Takuya Akiyama ◽  
Tomomi Yonekawa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Optic Nerve ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Posterior Column ◽  
Aquaporin 4 ◽  
Aqp4 Antibody ◽  
Sjögren‘S Syndrome

Background and objective: The objective of this study is to clarify clinical, immunological, and neuroimaging features in anti-aquaporin-4 (AQP4) antibody-positive and antibody-negative Sjögren’s syndrome (SS) patients with central nervous system (CNS) involvement. Methods: Medical records and MRI scans were retrospectively analyzed in 22 consecutive SS patients with CNS manifestations. Results: Seven (31.8%) patients were positive for anti-AQP4 antibodies. The frequency of visual impairment was higher in anti-AQP4 antibody-positive patients than in antibody-negative patients (71.4% vs. 0.0%, p = 0.0008). Brain MRI showed that discrete lesions were more commonly found in the cerebrum, brainstem, and optic nerve in anti-AQP4 antibody-positive patients than in antibody-negative patients ( p = 0.002, p = 0.006, and p = 0.004, respectively), while spinal cord MRI showed that posterior column lesions in the cervical spinal cord were more frequent in anti-AQP4 antibody-positive patients than in antibody-negative patients (71.4% vs. 14.3%, p = 0.01). SS-A antibody titers were higher in anti-AQP4 antibody-positive patients than in antibody-negative patients ( p = 0.012) and were also higher in patients with longitudinally extensive spinal cord lesions (LESCLs) than in those without LESCLs ( p = 0.019). Conclusions: In SS, the presence of anti-AQP4 antibodies is associated with involvement of the optic nerve, cerebrum and brainstem, and with cervical posterior column lesions in the spinal cord.

Neuromyelitis optica spectrum disorder (NMOSD) presenting as acute transverse myelitis with positive aquaporin 4 antibodies

2021 ◽  
Vol 14 (1) ◽  
pp. e238992
Author(s):  
Katherine Thornley ◽  
Carlo Canepa
Keyword(s):  
Spinal Cord ◽  
Transverse Myelitis ◽  
Aquaporin 4 ◽  
Sensory Level ◽  
Mri Scan ◽  
Acute Transverse Myelitis ◽  
Longitudinal Extensive Transverse Myelitis ◽  
Oral Steroids ◽  
Extensive Transverse Myelitis

An 80-year-old, previously healthy patient presents with acute transverse myelitis with sensory level at T8. The MRI scan of the spinal cord showed longitudinal extensive transverse myelitis, and she tested positive for aquaporin 4 antibodies in serum. She received treatment with intravenous and oral steroids, with no improvement and then underwent plasma exchange. She was then started on azathioprine for prevention of relapses, while continuing physiotherapy and occupational therapy. Eventually, she was transferred to a specialised spinal cord centre for long-term rehabilitation.

scholarly journals Long extensive transverse myelitis associated with aquaporin-4 antibody and breast cancer: Favorable response to cancer treatment

2012 ◽  
Vol 35 (4) ◽  
pp. 267-269 ◽  
Author(s):  
Haydar Armağan ◽  
Erdem Tüzün ◽  
Sema İçöz ◽  
Ömer Birişik ◽  
Canan Ulusoy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Transverse Myelitis ◽  
Aquaporin 4 ◽  
Aquaporin 4 Antibody ◽  
Extensive Transverse Myelitis
Sign in / Sign up

Export Citation Format

Share Document