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A comparative study on clinical characterizations between acute myelitis onset of neuromyelitis optica spectrum disease and idiopathic transverse myelitis.
Neurological Research ( IF 1.9 ) Pub Date : 2020-06-04 , DOI: 10.1080/01616412.2020.1773628
Zhuo Liu 1, 2, 3 , Meixin Xie 1, 4 , Zhengjuan Lu 1, 2, 3, 5 , Cunjin Zhang 1, 2, 3, 5 , Huiping Chen 1, 2, 3, 5 , Yun Xu 1, 2, 3, 5 , Meijuan Zhang 1, 2, 3, 5
Affiliation  

Background/Aims

Both of neuromyelitis optica spectrum disease (NMOSDs) and idiopathic transverse myelitis (ITM) could present as acute transverse myelitis. However, long-term immunological treatment and prognosis are different for high recurrence of NMOSDs. In this study, we summarized clinical differences between acute attack myelitis of NMOSDs and ITM, we further screened serum auto-antibodies to help understand the two distinct clinical entities.

Methods

This is a retrospective study on 48 NMOSD patients and 49 ITM patients in neurological department of Nanjing Drum Tower Hospital from 2013 to 2019. Clinical, CSF and MRI profiles on the acute episode were also compared between NMOSD patients and ITM patients. Serum AQP4 and auto-antibodies were tested. Clinical parameters were further compared between NMOSD patients with and without auto-antibodies.

Results

Compared with ITM patients, NMOSD patients manifested with longer vertebral segments (5.42 ± 3.17 segments vs. 2.31 ± 2.36 segments, p < 0.001), higher female/male ratio (13:3 vs. 20:29, p < 0.001), higher IgG index (30.30% vs. 9.09%, p < 0.05). Positive rates of anti-Ro-52 (47.92% vs. 14.29%, p < 0.001), anti-ANAs (50.00% vs.10.20%, p < 0.001) and anti-SSA (35.42% vs. 6.12%, p = 0.001) were significantly higher in the NMOSD patients than the ITM patients. Seropositive Ro-52 and SSA were associated with longer injured spinal cord segments. However, Ro-52 antibody may not be associated with NMOSD relapsing during our follow up.

Conclusions

NMOSD patients manifested with longer vertebral segments, higher female/male ratio, IgG index, anti-ANAs, anti-Ro-52 and anti-SSA seroprevalence than ITM patients. These features may help clinicians better distinguish NMOSD from ITM and provide long-term immunotherapy reasonably.



中文翻译:

视神经脊髓炎频谱疾病的急性脊髓炎发作与特发性横纹肌炎之间临床特征的比较研究。

背景/目标

视神经脊髓炎频谱疾病(NMOSDs)和特发性横纹肌炎(ITM)均可表现为急性横纹肌炎。但是,对于NMOSD的高复发率,长期免疫治疗和预后不同。在这项研究中,我们总结了NMOSD和ITM的急性发作性脊髓炎之间的临床差异,我们进一步筛选了血清自身抗体以帮助理解这两种不同的临床实体。

方法

这是对2013年至2019年南京鼓楼医院神经内科的48例NMOSD患者和49例ITM患者的回顾性研究。还比较了NMOSD患者和ITM患者急性发作的临床,CSF和MRI资料。测试了血清AQP4和自身抗体。在具有和不具有自身抗体的NMOSD患者之间进一步比较了临床参数。

结果

与ITM患者相比,NMOSD患者的椎体节段更长(5.42±3.17节vs. 2.31±2.36节,p <0.001),女性/男性比例更高(13:3 vs. 20 :29,p <0.001),更高IgG指数(30.30%9.09%,p <0.05)。抗Ro-52(47.92%vs . 14.29%,p <0.001),抗ANAs(50.00%vs .10.20%,p <0.001)和抗SSA(35.42%vs . 6.12%,p = NMOSD患者的0.001)显着高于ITM患者。血清阳性的Ro-52和SSA与更长的脊髓损伤段有关。但是,在我们的随访过程中,Ro-52抗体可能与NMOSD复发无关。

结论

与ITM患者相比,NMOSD患者表现出更长的椎骨节段,更高的男女比例,IgG指数,抗ANAs,抗Ro-52和抗SSA血清阳性率。这些功能可以帮助临床医生更好地将NMOSD与ITM区别开,并合理地提供长期免疫治疗。

更新日期:2020-06-19
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