Value of NMO-IgG determination at the time of presentation as CIS

被引:19
作者
Costa, C. [1 ]
Arrambide, G. [1 ]
Tintore, M. [1 ]
Castillo, J. [1 ]
Sastre-Garriga, J. [1 ]
Tur, C. [1 ]
Rio, J. [1 ]
Saiz, A. [3 ]
Vidal-Jordana, A. [1 ]
Auger, C. [1 ,2 ]
Nos, C.
Rovira, A. [2 ]
Comabella, M. [1 ]
Horga, A. [1 ]
Montalban, X. [1 ]
机构
[1] Univ Autonoma Barcelona, Hosp Univ Vall Hebron, Unitat Neuroimmunol Clin UNiC, Ctr Esclerosi Multiple Catalunya CEM Cat,VHIR, Barcelona, Spain
[2] Univ Autonoma Barcelona, Hosp Univ Vall Hebron, Magnet Resonance Unit IDI, Dept Radiol, Barcelona, Spain
[3] Univ Barcelona, Hosp Clin, Serv Neurol, E-08007 Barcelona, Spain
关键词
REVISED DIAGNOSTIC-CRITERIA; NEUROMYELITIS-OPTICA;
D O I
10.1212/WNL.0b013e3182563b32
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Despite the availability of diagnostic criteria, an overlap between neuromyelitis optica (NMO) and multiple sclerosis (MS) exists, particularly in the early stage of the disease. Objective: To study the value of NMO-immunoglobulin G (IgG) determination in Caucasian patients with a first demyelinating episode who develop a relapsing form of optic neuritis or myelitis. Methods: This study was based on a prospectively acquired cohort of patients regarded as having a clinically isolated syndrome (CIS) at the time of presentation. From this cohort, 2 different groups were selected: group 1 (NMO phenotype), consisting of a first attack involving the optic nerve or the spinal cord, and at least a second event affecting either topography, and group 2 (negative control group), consisting of a first attack involving the brainstem or the cerebral hemispheres and at least 1 relapse in any topography. Group 3 was composed of patients with NMO according to the 2006 revised diagnostic criteria. Serum NMO-IgG was determined by indirect immunofluorescence. Results: A total of 3.1% of the group 1 patients were positive for NMO-IgG in comparison to 3.9% of group 2 and 44.5% of group 3, NMO. One of the positive patients in group 1 evolved to NMO. Conclusions: NMO-IgG determination is crucial in detecting patients who will develop NMO; however, its value as a routine test in cases presenting with symptoms of the type seen in MS is low, and should only be performed in those patients in which the initial diagnosis is not clear. Neurology (R) 2012;78:1608-1611
引用
收藏
页码:1608 / 1611
页数:4
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