Author(s): Siritho S, Apiwattanakul M, Nakashima I, Takahashi T, Fujihara K,
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Abstract OBJECTIVE: The aim of this study is to investigate the unique features of seronegative neuromyelitis optica spectrum disorders (NMOSD) in Thailand. BACKGROUND: It remains unknown whether seronegative NMOSD patients possess clinical and paraclinical features that are distinct from those with seropositivity. METHODS: In a Thai cohort of idiopathic inflammatory CNS disorders (n=122), 52 patients fulfilled the Wingerchuk 2007 criteria for NMOSD. We determined anti-AQP4 antibody statuses using three different assays (an in-house cell-based assay [CBA], a commercially available CBA and a tissue-based indirect immunofluorescence [IIF] assay). RESULTS: Among the NMOSD patients, the percentage of seropositive cases was 54.5\% based on the in-house and commercial CBAs and 30.8\% based on the IIF assay. Using the in-house CBA, seronegative NMOSD patients exhibited distinct features compared with seropositive patients, such as a lack of female preponderance (F/M=1.2 vs. 6.0), frequent simultaneous bilateral optic involvement (33.3\% vs. 0.04\%), a lower annual relapse rate (0.4 ± 0.3 vs. 0.7 ± 0.6), fewer spinal cord lesions (1.0 ± 4.3 vs. 1.4 ± 0.6), and lower CSF cell counts (20 ± 72 vs. 80 ± 285). Use of the commercial CBA yielded essentially similar results, but some of these differences were not significant using IIF. CONCLUSIONS: Sensitive anti-AQP4 antibody assays reveal features of seronegative NMOSD patients that differ from those of seropositive patients from Thailand. Copyright © 2014 Elsevier B.V. All rights reserved.
This article was published in J Neurol Sci
and referenced in Journal of Multiple Sclerosis