Very late-onset neuromyelitis optica spectrum disorder beyond the age of 75

被引：48

作者：

Krumbholz, Markus ^{[1
]}

Hofstadt-van Oy, Ulrich ^{[2
]}

Angstwurm, Klemens ^{[3
]}

Kleiter, Ingo ^{[4
]}

Jarius, Sven ^{[5
]}

Paul, Friedemann ^{[6
,7
]}

Aktas, Orhan ^{[8
]}

Buchholz, Grete ^{[9
]}

Kern, Peter ^{[10
]}

Straube, Andreas ^{[9
]}

Kuempfel, Tania ^{[1
]}

机构：

[1] Univ Munich, Inst Clin Neuroimmunol, D-81377 Munich, Germany

[2] Klinikum Bayreuth, Klin Hohe Warte, Neurol Klin, Bayreuth, Germany

[3] Univ Regensburg, Dept Neurol, D-93053 Regensburg, Germany

[4] Ruhr Univ Bochum, St Josef Hosp, Dept Neurol, Bochum, Germany

[5] Heidelberg Univ, Dept Neurol, Mol Neuroimmunol Grp, Heidelberg, Germany

[6] Charite, NeuroCure Clin Res Ctr, D-13353 Berlin, Germany

[7] Charite, Dept Neurol, D-13353 Berlin, Germany

[8] Univ Dusseldorf, Dept Neurol, Fac Med, Dusseldorf, Germany

[9] Univ Munich, Dept Neurol, D-81377 Munich, Germany

[10] Asklepios Fachklinikum, Klin Neurol & Klin Neurophysiol, Teupitz, Germany

来源：

JOURNAL OF NEUROLOGY | 2015年 / 262卷 / 05期

基金：

欧盟第七框架计划;

关键词：

Neuromyelitis optica (Devic syndrome); Myelitis; Aquaporin; 4; antibodies; Very late-onset; Elderly/old-age; Therapy/immunosuppression; MULTIPLE-SCLEROSIS; MULTICENTER; DISEASE;

D O I：

10.1007/s00415-015-7766-8

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Aquaporin-4 antibody (AQP4-Ab)-positive neuromyelitis optica spectrum disorder (NMOSD) is a rare but often severe autoimmune disease with median onset around 40 years of age. We report characteristics of three very-late-onset NMOSD (including complete NMO) patients > 75 years of age, in whom this diagnosis initially seemed unlikely because of their age and age-associated concomitant diseases, and briefly review the literature. All three patients, aged 79, 82 and 88 years, presented with a spinal cord syndrome as the first clinical manifestation of AQP4-Ab-positive NMOSD. They all had severe relapses unless immunosuppressive therapy was initiated, and one untreated patient died of a fatal NMOSD course. Two patients developed side effects of immunosuppression. We conclude that a first manifestation of NMOSD should be considered even in patients beyond the age of 75 years with a compatible syndrome, especially longitudinally extensive myelitis. Early diagnosis and treatment are feasible and highly relevant. Special attention is warranted in the elderly to recognize adverse effects of immunosuppressive therapies as early as possible.

引用

页码：1379 / 1384

页数：6

共 18 条

[1] Neuromyelitis Optica in Austria in 2011: To Bridge the Gap between Neuroepidemiological Research and Practice in a Study Population of 8.4 Million People [J].

Aboul-Enein, Fahmy ;

Seifert-Held, Thomas ;

Mader, Simone ;

Kuenz, Bettina ;

Lutterotti, Andreas ;

Rauschka, Helmut ;

Rommer, Paulus ;

Leutmezer, Fritz ;

Vass, Karl ;

Flamm-Horak, Agathe ;

Stepansky, Robert ;

Lang, Wilfried ;

Fertl, Elisabeth ;

Schlager, Thomas ;

Heller, Thomas ;

Eggers, Christian ;

Safoschnik, Georg ;

Fuchs, Siegrid ;

Kraus, Joerg ;

Assar, Hamid ;

Guggenberger, Stefan ;

Reisz, Martin ;

Schnabl, Peter ;

Komposch, Martina ;

Simschitz, Philipp ;

Skrobal, Alena ;

Moser, Alexander ;

Jeschow, Mario ;

Stadlbauer, Dorothea ;

Freimueller, Manfred ;

Guger, Michael ;

Schmidegg, Susanne ;

Franta, Claudia ;

Weiser, Vera ;

Koppi, Stefan ;

Niederkorn-Duft, Margret ;

Raber, Bettina ;

Schmeissner, Iris ;

Jecel, Julia ;

Tinchon, Alexander ;

Storch, Maria K. ;

Reindl, Markus ;

Berger, Thomas ;

Kristoferitsch, Wolfgang .

PLOS ONE, 2013, 8 (11)

[2]

Ahn SW, 2011, 5 JOINT TRIENN C EUR

[3] Treatment of NMO relapse in the elderly: rituximab when plasma exchange fails? [J].

Bourre, B. ;

Lefaucheur, R. ;

Girault, C. .

ACTA NEUROLOGICA BELGICA, 2013, 113 (03) :335-336

[4] Characterization of neuromyelitis optica and neuromyelitis optica spectrum disorder patients with a late onset [J].

Collongues, N. ;

Marignier, R. ;

Jacob, A. ;

Leite, M. I. ;

Sivas, A. ;

Paul, F. ;

Zephir, H. ;

Akman-Demirs, G. ;

Elsone, L. ;

Jarius, S. ;

Papeix, C. ;

Mutch, K. ;

Saips, S. ;

Wildemann, B. ;

Kitley, J. ;

Karabudak, R. ;

Aktas, O. ;

Kuscu, D. ;

Altintas, A. ;

Palace, J. ;

Confavreux, C. ;

De Seze, J. .

MULTIPLE SCLEROSIS JOURNAL, 2014, 20 (08) :1086-1094

[5] Neuromyelitis optica in France A multicenter study of 125 patients [J].

Collongues, N. ;

Marignier, R. ;

Zephir, H. ;

Papeix, C. ;

Blanc, F. ;

Ritleng, C. ;

Tchikviladze, M. ;

Outteryck, O. ;

Vukusic, S. ;

Fleury, M. ;

Fontaine, B. ;

Brassat, D. ;

Clanet, M. ;

Milh, M. ;

Pelletier, J. ;

Audoin, B. ;

Ruet, A. ;

Lebrun-Frenay, C. ;

Thouvenot, E. ;

Camu, W. ;

Debouverie, M. ;

Creange, A. ;

Moreau, T. ;

Labauge, P. ;

Castelnovo, G. ;

Edan, G. ;

Le Page, E. ;

Defer, G. ;

Barroso, B. ;

Heinzlef, O. ;

Gout, O. ;

Rodriguez, D. ;

Wiertlewski, S. ;

Laplaud, D. ;

Borgel, F. ;

Tourniaire, P. ;

Grimaud, J. ;

Brochet, B. ;

Vermersch, P. ;

Confavreux, C. ;

de Seze, J. .

NEUROLOGY, 2010, 74 (09) :736-742

[6] Seroprevalence of Autoantibodies against Brain Antigens in Health and Disease [J].

Dahm, Liane ;

Ott, Christoph ;

Steiner, Johann ;

Stepniak, Beata ;

Teegen, Bianca ;

Saschenbrecker, Sandra ;

Hammer, Christian ;

Borowski, Kathrin ;

Begemann, Martin ;

Lemke, Sandra ;

Rentzsch, Kristin ;

Probst, Christian ;

Martens, Henrik ;

Wienands, Juergen ;

Spalletta, Gianfranco ;

Weissenborn, Karin ;

Stoecker, Winfried ;

Ehrenreich, Hannelore .

ANNALS OF NEUROLOGY, 2014, 76 (01) :82-94

[7] NEUROMYELITIS OPTICA IN THE ELDERLY [J].

FILLEY, CM ;

STERNBERG, PE ;

NORENBERG, MD .

ARCHIVES OF NEUROLOGY, 1984, 41 (06) :670-672

[8] NEUROMYELITIS OPTICA IN THE OLD-AGE - A CLINICOPATHOLOGICAL CONTRIBUTION [J].

GHEZZI, M ;

GIANSANTI, M ;

MALENTACCHI, GM ;

BARONTINI, F .

ITALIAN JOURNAL OF NEUROLOGICAL SCIENCES, 1987, 8 (06) :613-616

[9] Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: A multicentre study of 175 patients [J].

Jarius, Sven ;

Ruprecht, Klemens ;

Wildemann, Brigitte ;

Kuempfel, Tania ;

Ringelstein, Marius ;

Geis, Christian ;

Kleiter, Ingo ;

Kleinschnitz, Christoph ;

Berthele, Achim ;

Brettschneider, Johannes ;

Hellwig, Kerstin ;

Hemmer, Bernhard ;

Linker, Ralf A. ;

Lauda, Florian ;

Mayer, Christoph A. ;

Tumani, Hayrettin ;

Melms, Arthur ;

Trebst, Corinna ;

Stangel, Martin ;

Marziniak, Martin ;

Hoffmann, Frank ;

Schippling, Sven ;

Faiss, Juergen H. ;

Neuhaus, Oliver ;

Ettrich, Barbara ;

Zentner, Christian ;

Guthke, Kersten ;

Hofstadt-van Oy, Ulrich ;

Reuss, Reinhard ;

Pellkofer, Hannah ;

Ziemann, Ulf ;

Kern, Peter ;

Wandinger, Klaus P. ;

Bergh, Florian Then ;

Boettcher, Tobias ;

Langel, Stefan ;

Liebetrau, Martin ;

Rommer, Paulus S. ;

Niehaus, Sabine ;

Muench, Christoph ;

Winkelmann, Alexander ;

Zettl U, Uwe K. ;

Metz, Imke ;

Veauthier, Christian ;

Sieb, Joern P. ;

Wilke, Christian ;

Hartung, Hans P. ;

Aktas, Orhan ;

Paul, Friedemann .

JOURNAL OF NEUROINFLAMMATION, 2012, 9

[10] Clinical characteristics of patients with late-onset multiple sclerosis [J].

Kis, Bernhard ;

Rumberg, Bastian ;

Berlit, Peter .

JOURNAL OF NEUROLOGY, 2008, 255 (05) :697-702

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