The neuromyelitis optica presentation and the aquaporin-4 antibody in HIV-seropositive and seronegative patients in KwaZulu-Natal, South Africa.
The neuromyelitis optica presentation and the aquaporin-4 antibody in HIV-seropositive and seronegative patients in KwaZulu-Natal, South Africa.
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DOI：
10.4102/sajhivmed.v18i1.684
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发表时间：
2017
影响因子：
1.7
通讯作者：
Esser M
中科院分区：
文献类型：
--
作者：
Bhigjee AI;Moodley AA;Roos I;Wells CL;Ramdial P;Esser M
抗水通道蛋白-4 （AQP-4）水通道抗体与视神经脊髓炎（NMO）综合征的关系已从世界各地报道。目前还没有大型研究描述HIV流行地区南部非洲的这种关联。HIV患者通常表现为视觉障碍或脊髓病变的特征，但很少同时或连续出现。我们报告了我们在南非夸祖鲁-纳塔尔省hiv阳性和hiv阴性患者AQP-4检测时代的NMO经验。回顾性分析了2005年1月至2016年4月在两个神经病学单位为710万成年人服务的NMO病例。从档案中提取临床、放射学及相关实验室资料进行分析。12例hiv阳性患者（平均年龄33岁），9例（75%）为女性，12例均为黑人患者。在17例hiv阴性患者（平均年龄32岁）中，15例（88%）为女性，10例（59%）为黑人。两组的临床特征为孤立性视神经炎、孤立性纵向广泛脊髓炎或合并。6例hiv阳性患者和6例hiv阴性患者反复发作。AQP-4抗体在4/10 (40%)hiv阳性患者和11/13 (85%)hiv阴性患者中呈阳性。影像学改变为纵向高强度脊髓病变和视神经长节段强化病变。3例患者均为hiv阳性，肿瘤病变伴不完全环形强化。这项研究证实了南部非洲hiv阳性和hiv阴性患者中aqp -4阳性NMO的存在。当hiv阳性患者同时或连续出现视神经炎和脊髓炎时，应提醒临床医生检测AQP-4抗体。重要的是要认识到这种临床综合征的具体治疗是可行的。我们进一步假设HIV本身可能作为自身免疫过程的触发因素。
The association of the anti-aquaporin-4 (AQP-4) water channel antibody with neuromyelitis optica (NMO) syndrome has been described from various parts of the world. There has been no large study describing this association from southern Africa, an HIV endemic area. HIV patients often present with visual disturbance or features of a myelopathy but seldom both either simultaneously or consecutively. We report our experience of NMO in the era of AQP-4 testing in HIV-positive and HIV-negative patients seen in KwaZulu-Natal, South Africa. A retrospective chart review was undertaken of NMO cases seen from January 2005 to April 2016 in two neurology units serving a population of 7.1 million adults. The clinical, radiological and relevant laboratory data were extracted from the files and analysed. There were 12 HIV-positive patients (mean age 33 years), 9 (75%) were women and all 12 were black patients. Of the 17 HIV-negative patients (mean age 32 years), 15 (88%) were women and 10 (59%) were black people. The clinical features in the two groups ranged from isolated optic neuritis, isolated longitudinally extensive myelitis or combinations. Recurrent attacks were noted in six HIV-positive patients and six HIV-negative patients. The AQP-4 antibody was positive in 4/10 (40%) HIV-positive patients and 11/13 (85%) HIV-negative patients. The radiological changes ranged from longitudinal hyperintense spinal cord lesions and long segment enhancing lesions of the optic nerves. Three patients, all HIV-positive, had tumefactive lesions with incomplete ring enhancement. This study confirms the presence of AQP-4-positive NMO in southern Africa in both HIV-positive and HIV-negative patients. The simultaneous or consecutive occurrence of optic neuritis and myelitis in an HIV-positive patient should alert the clinician to test for the AQP-4 antibody. It is important to recognise this clinical syndrome as specific therapy is available. We further postulate that HIV itself may act as a trigger for an autoimmune process.
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影响因子：
9.9
作者：
Wingerchuk DM;Banwell B;Bennett JL;Cabre P;Carroll W;Chitnis T;de Seze J;Fujihara K;Greenberg B;Jacob A;Jarius S;Lana-Peixoto M;Levy M;Simon JH;Tenembaum S;Traboulsee AL;Waters P;Wellik KE;Weinshenker BG;International Panel for NMO Diagnosis
通讯作者：
International Panel for NMO Diagnosis
影响因子：
5.8
作者：
Feyissa, Anteneh M.;Singh, Parbhdeep;Smith, Robert G.
通讯作者：
Smith, Robert G.
影响因子：
4.9
作者：
Kang, Eun-suk;Min, Ju-Hong;Kim, Byoung Joon
通讯作者：
Kim, Byoung Joon
DOI：
10.1177/1352458515572406
发表时间：
2015-06
期刊：
Multiple sclerosis (Houndmills, Basingstoke, England)
影响因子：
--
作者：
Pandit L;Asgari N;Apiwattanakul M;Palace J;Paul F;Leite MI;Kleiter I;Chitnis T;GJCF International Clinical Consortium & Biorepository for Neuromyelitis Optica
通讯作者：
GJCF International Clinical Consortium & Biorepository for Neuromyelitis Optica
影响因子：
6
作者：
Ghezzi, A;Bergamaschi, R;Comi, G
通讯作者：
Comi, G