Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis
Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis
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DOI：
10.1002/ana.20770
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发表时间：
2006-03-01
影响因子：
11.2
通讯作者：
Lennon, VA
中科院分区：
文献类型：
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作者：
Weinshenker, BG;Wingerchuk, DM;Lennon, VA
目标。我们调查了视神经脊髓炎(NMO)在纵向广泛横贯性脊髓炎(LETM)初期的血清抗体阳性是否预示脊髓炎的复发或视神经炎的发展。方法：对初发LETM患者进行NMO-IgG检测，进行前瞻性研究。结果：29例患者中有11例(37.9%)在磁共振成像上首次发作跨越三个或更多椎体节段的LETM后血清阳性。23例患者随访1年，14例血清阴性的患者无一例复发或发展为视神经炎。在9例CsC阳性患者中，5例发生了第二次事件：4例(44%)发展为复发性横贯性脊髓炎，1例(11%)发展为视神经炎(p=0.004)。解释：LETM在很高比例的患者中代表了一种首发或有限的NMO形式。血清NMO-Ig G阳性的患者中有40%的患者复发的风险很高。
Objective. We investigated whether neuromyelitis optica (NMO) IgG seropositivity at the initial presentation of longitudinally extensive transverse myelitis (LETM) predicts relapse of myelitis or development of optic neuritis. Methods: Prospective study of patients with initial LETM who were tested for the presence of NMO-IgG. Results: Eleven of 29 patients (37.9%) were seropositive after a first attack of LETM spanning three or more vertebral segments on magnetic resonance imaging. Of 23 patients followed up for I year, none of 14 who were seronegative experienced a relapse or developed optic neuritis. Of 9 scropositive patients, 5 developed a second event: 4 of 9 (44%) developed recurrent transverse myelitis and 1 of 9 (11%) developed optic neuritis (p = 0.004). Interpretation: LETM represents an inaugural or limited form of NMO in a high proportion of patients. The 40% of patients who are seropositive for NMO-IgG arc at high risk for relapse.