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
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A nationwide survey of pediatric acquired demyelinating syndromes in Japan.
Yui Yamaguchi,Hiroyuki Torisu,Hiroyuki Torisu,Ryutaro Kira,Yoshito Ishizaki,Yasunari Sakai,Masafumi Sanefuji,Takashi Ichiyama,Akira Oka,Takayuki Kishi,Sadami Kimura,Motoo Kubota,Jun-ichi Takanashi,Yukitoshi Takahashi,Hiroshi Tamai,Jun Natsume,Shin-ichiro Hamano,Shinichi Hirabayashi,Yoshihiro Maegaki,Masashi Mizuguchi,K. Minagawa,Hiroaki Yoshikawa,Jun Ichi Kira,Susumu Kusunoki,Toshiro Hara +24 more
TL;DR: The results clarify the characteristic clinical features of pediatric ADS in the Japanese population and show that NMO in Japan was rare, and the sex ratio and mean age at onset varied by ADS type.
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Intermittent intravenous immunoglobulin successfully prevents relapses of neuromyelitis optica.
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Brain MRI abnormalities in neuromyelitis optica.
TL;DR: In this paper, the authors explored brain MRI findings in neuromyelitis optica and investigated specific brain lesions with respect to the localization of aquaporin-4 (AQP-4).
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The immune balance between memory and regulatory B cells in NMO and the changes of the balance after methylprednisolone or rituximab therapy.
Chao Quan,Jingzi ZhangBao,Jiahong Lu,Chongbo Zhao,Tongjia Cai,Bei Wang,Hai Yu,Jian Qiao,Chuanzhen Lu +8 more
TL;DR: HMT and rituximab had basically different impacts on B cells in NMO, which restored the numerical balance between Breg and Bmem back to an advantageous "Breg>Bmem" status.
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The effect of intravenous immunoglobulin on neuromyelitis optica
TL;DR: Treatment with IVIG is safe and well-tolerated, and it may be used as a treatment alternative for NMO spectrum disorders.
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Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
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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.
TL;DR: It is shown that NMO-IgG binds selectively to the aquaporin-4 water channel, a component of the dystroglycan protein complex located in astrocytic foot processes at the blood-brain barrier, which may represent the first example of a novel class of autoimmune channelopathy.
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