Cerebrospinal fluid/serum immunoglobulin G quotient is predictive of unresponsiveness to intravenous methylprednisolone therapy for acute exacerbation of neuromyelitis optica spectrum disorder

2016 ◽  
Vol 7 (3) ◽  
pp. 209-210
Author(s):  
Kazumasa Okada
Keyword(s):  
Cerebrospinal Fluid ◽  
Acute Exacerbation ◽  
Neuromyelitis Optica ◽  
Immunoglobulin G ◽  
Spectrum Disorder ◽  
Serum Immunoglobulin ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Intravenous Methylprednisolone

Serum Immunoglobulin G level and Neutrophils to Lymphocytes Ratio Associated with the Prognosis of Neuromyelitis Optica Spectrum Disorder

2021 ◽  
Vol 18 ◽  
Author(s):  
Ying Tong ◽  
Li Wang ◽  
Kai Liu ◽  
Weishi Liu ◽  
Shen Li ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Neuromyelitis Optica ◽  
Immunoglobulin G ◽  
Peripheral Blood ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Positive Group ◽  
Serum Igg ◽  
High Level ◽  
Igg Level

Objective: To investigate the factors related to the prognosis of neuromyelitis optica spectrum disorder (NMOSD) in cerebrospinal fluid and peripheral blood examination. Methods: In this study, we collected 111 patients who were admitted to the First Affiliated Hospital of Zhengzhou University between January 2016 and January 2018 and diagnosed with NMOSD. The patients were divided into the relapse group (n=48) and remission group (n=67). Before treatment, all the patients underwent a routine cerebrospinal fluid (CSF) and peripheral blood test on the second morning of admission. The association between laboratory data and disease prognosis was evaluated. Results: The immunoglobulin G (IgG) level in the serum showed a strong correlation with the relapse of patients, especially in the aquaporin-4-Antibody (AQP4-Ab) positive group (p<0.01). A high level of serum IgG concentration was associated with the relapse of NMOSD, especially in the anti-AQP4 positive group. The area under the receiver operating characteristic (ROC) curve of serum IgG level was 0.888 (p0.001, 95%CI: 0.808-0.968). The ratio of neutrophils to lymphocytes (NLR) was associated with the disability degree of NMOSD patients in 3 years. The NLR value was a linear correlation with final Expanded Disability Status Scale (EDSS) scores. Patients with a high level of NLR value presented an increased degree of disability in the following three years (R2=0.053, p=0.015). Conclusion: The serum IgG level and NLR of first-attack patients were correlated with the prognosis of NMOSD.

scholarly journals Neuromyelitis optica spectrum disorder and adenocarcinoma of ovary: a novel association

2019 ◽  
Vol 12 (4) ◽  
pp. e227435
Author(s):  
Julie Sachdeva ◽  
Ramandeep Bansal ◽  
Aastha Takkar ◽  
Rajveer Singh
Keyword(s):  
Neuromyelitis Optica ◽  
Spectrum Disorder ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Intravenous Methylprednisolone ◽  
Novel Association ◽  
Carcinoma Ovary

Paraneoplastic neuromyelitis optica spectrum disorder (NMOSD) is a rare clinical entity with less than 40 cases described in literature until today. Paraneoplastic NMOSD in association with adenocarcinoma of ovary has not been described yet. We present a case of paraneoplastic NMOSD in association with carcinoma ovary which improved following appropriate immunomodulation with pulse intravenous methylprednisolone and azathioprine.

A Girl With Back Pain, Paresthesias, and Painful Vision Loss

2021 ◽  
pp. 44-47
Author(s):  
Cecilia Zivelonghi ◽  
Andrew McKeon
Keyword(s):  
Back Pain ◽  
Neuromyelitis Optica ◽  
Immunoglobulin G ◽  
Vision Loss ◽  
Spectrum Disorder ◽  
Aquaporin 4 ◽  
Lower Limbs ◽  
First Episode ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Anti Cd20

A 12-year-old girl sought care for subacute onset of cramping back pain, along with paresthesias in her lower limbs up to the waistline, both hands, upper back, and chest, followed by rapidly progressive (over a few hours) painful vision loss affecting initially the right eye with subsequent involvement of the left eye. She underwent neuroophthalmologic evaluation and was diagnosed with bilateral optic neuritis. A positive Lhermitte sign was also present. The patient was tested for aquaporin-4-immunoglobulin G autoantibodies, which were positive in both serum and cerebrospinal fluid. A diagnosis of aquaporin-4-immunoglobulin G–positive neuromyelitis optica was made. The patient was treated with rituximab (anti-CD20 monoclonal antibody) and became episode-free, with no further accumulation of disability. The discovery of aquaporin-4-immunoglobulin G in 2004 has permitted the distinction of neuromyelitis optica spectrum disorder from other inflammatory central nervous system disorders. Aquaporin-4-immunoglobulin G represents a highly specific biomarker for neuromyelitis optica (almost 100% using molecular-based techniques), with sensitivity of approximately 80%. According to the most recent diagnostic criteria published in 2015, a diagnosis of neuromyelitis optica spectrum disorder can also be made for patients who are aquaporin-4-immunoglobulin G seronegative by any testing method, regardless of assay sensitivity, provided that more stringent clinical and radiologic requirements are met. Serial testing is recommended for these patients because late seroconversion has been described up to 4 years after the first episode.

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