Neuromyelitis Optica IgG Predicts Relapse After Longitudinally Extensive Transverse Myelitis

Overview

Journal Ann Neurol

Specialty Neurology

Date 2006 Feb 3

PMID 16453327

Citations 153

Authors

Brian G Weinshenker

Dean M Wingerchuk

Sandra Vukusic

Linda Linbo

Sean J Pittock

Claudia F Lucchinetti

Vanda A Lennon

Affiliations

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Abstract

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 1 year, none of 14 who were seronegative experienced a relapse or developed optic neuritis. Of 9 seropositive 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 are at high risk for relapse.

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