Analysis of 103 Hungarian patients with neuromyelitis optica spectrum disease

M. Banati, E. Koszegi, P. Csecsei, L. Bors, B. Hemmer, A. Berthele, T. Molnar, T. Csepany, C. Rozsa, M. Simo, G. Jakab, S. Komoly, Z. Illes (Pecs, HU; Munich, DE; Debrecen, Budapest, HU)

Objectives: Neuromyelitis optica (NMO) is an antibody(Ab)-mediated immune disorder directed against aquaporin 4 (AQP4). In a part of cases the clinical syndrome is incomplete, and only relapsing/bilateral optic neuritis (RION/BON) or longitudinally extensive transverse myelitis (LETM) are detected.
Methods: We compared 103 patients with NMO spectrum (37 NMO, 28 RION and 38 LETM) to 159 patients with relapsing-remitting multiple sclerosis (RRMS) and 92 patients with non-NMO. AQP4 molecules are also expressed in gastrointestinal (GI) tract. Therefore we examined the presence of GI Abs in the sera of patients with NMO spectrum and patients with MS.
Results: The percentage of females and age at onset were higher in NMO spectrum compared to MS (p< =0.01). Relapse frequency was higher in AQP4+ cases (p<0.001) and 22% of 125 relapses were preceded by infections. Mean EDSS was higher after a shorter follow-up in NMO compared to RRMS. Non-NMO controls had no anti-AQP4 Abs in contrast to NMO, LETM and RION (pConclusion: Based on our data, we propose differential diagnostic and therapeutic algorhythms of NMO spectrum.

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