Revised diagnostic criteria for neuromyelitis optica
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TLDR
Revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity.Abstract:
Background: The authors previously proposed diagnostic criteria for neuromyelitis optica (NMO) that facilitate its distinction from prototypic multiple sclerosis (MS) However, some patients with otherwise typical NMO have additional symptoms not attributable to optic nerve or spinal cord inflammation or have MS-like brain MRI lesions Furthermore, some patients are misclassified as NMO by the authors’ earlier proposed criteria despite having a subsequent course indistinguishable from prototypic MS A serum autoantibody marker, NMO-IgG, is highly specific for NMO The authors propose revised NMO diagnostic criteria that incorporate NMO-IgG status Methods: Using final clinical diagnosis (NMO or MS) as the reference standard, the authors calculated sensitivity and specificity for each criterion and various combinations using a sample of 96 patients with NMO and 33 with MS The authors used likelihood ratios and logistic regression analysis to develop the most practical and informative diagnostic model Results: Fourteen patients with NMO (146%) had extra-optic-spinal CNS symptoms NMO-IgG seropositivity was 76% sensitive and 94% specific for NMO The best diagnostic combination was 99% sensitive and 90% specific for NMO and consisted of at least two of three elements: longitudinally extensive cord lesion, onset brain MRI nondiagnostic for MS, or NMO-IgG seropositivity Conclusions: The authors propose revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity CNS involvement beyond the optic nerves and spinal cord is compatible with NMOread more
Citations
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Journal ArticleDOI
Post-acute serum eosinophil and neutrophil-associated cytokine/chemokine profile can distinguish between patients with neuromyelitis optica and multiple sclerosis; and identifies potential pathophysiological mechanisms - a pilot study.
Benedict D Michael,Liene Elsone,Michael J. Griffiths,Brian Faragher,Ray Borrow,Tom Solomon,Tom Solomon,Anu Jacob +7 more
TL;DR: This study has identified and confirmed some key cytokine/chemokine markers in NMO distinct from MS, and shed further light on the importance of specific inflammatory mediators with predominant function in the differentiation, chemotaxis and activity of neutrophils and eosinophils, particularly CCL4, CCL11, granulocyte-colony stimulating factor and myeloperoxidase.
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Heterogeneity and continuum of multiple sclerosis in Japanese according to magnetic resonance imaging findings
Takeshi Matsuoka,Takuya Matsushita,Manabu Osoegawa,Hirofumi Ochi,Yuji Kawano,Futoshi Mihara,Yasumasa Ohyagi,Jun Ichi Kira +7 more
TL;DR: It is suggested that LESCLs are heterogeneous between OSMS and CMS patients, and that there are distinct subtypes of MS in Japanese, according to clinical and MRI findings.
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3'UTR C2370A allele of the IL-23 receptor gene is associated with relapsing-remitting multiple sclerosis.
Zsolt Illes,Eniko Safrany,Agnes Peterfalvi,Lili Magyari,Bernadett Faragó,Eva Pozsonyi,Csilla Rozsa,Sámuel Komoly,Béla Melegh +8 more
TL;DR: Data indicate that IL23R represents a novel shared susceptibility gene as its association with inflammatory bowel disease (IBD) has recently been verified.
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Neuromyelitis optica and neuromyelitis optica spectrum disorders.
TL;DR: The concept of NMOSD is opening a new era in clinical practice, allowing an easier and more homogeneous diagnosis and an increase in newly identified cases, which will facilitate clinical studies and support new therapeutic trial.
Journal ArticleDOI
Neuromyelitis optica (NMO)--an autoimmune disease of the central nervous system (CNS).
Nasrin Asgari,Trevor Owens,Jørgen Frøkiær,Egon Stenager,Søren Thue Lillevang,Kirsten Ohm Kyvik +5 more
TL;DR: Asgari N, Owens T, Frøkiær J, Stenager E, Lillevang ST, Kyvik KO Neuromyelitis optica – an autoimmune disease of the central nervous system (CNS).
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A serum autoantibody marker of neuromyelitis optica : distinction from multiple sclerosis
Vanda A. Lennon,Dean M. Wingerchuk,Thomas J. Kryzer,Sean J. Pittock,C. F. Lucchinetti,Kazuo Fujihara,Ichiro Nakashima,Brian G. Weinshenker +7 more
TL;DR: NMO-IgG is a specific marker autoantibody of neuromyelitis optica and binds at or near the blood-brain barrier that distinguishes neuromyleitis opticas from multiple sclerosis.
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IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel.
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