Neuromyelitis optica-IgG testing in an Indian cohort with neuromyelitis optica and related demyelinating disorders: Our experience

• Published in: Annals of the Indian Academy of Neurology Vol. 16; no. 3; pp. 376 - 379
• Main Authors: Unni, Narayanan, Barhate, Kavita, Ahmad, Nisha, Ganeshan, Malti, Singhal, Bhim
• Format: Journal Article
• Language: English
• Published: India Medknow Publications 01-07-2013; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Anti-aquaporin-4 seropositivity; Aquaporins; Care and treatment; Case studies; Cohort analysis; Complications and side effects; Demyelinating diseases; Diagnosis; Disease; Distribution; Flow cytometry; Immunoglobulin G; Methods; Multiple sclerosis; Neuromyelitis optica; neuromyelitis optica-Immunoglobulin G seropositivity; NMR; Nuclear magnetic resonance; Original; Patients; Properties; Studies; transverse myelitis; India; transverse myelitis; Anti-aquaporin-4 seropositivity; neuromyelitis optica-Immunoglobulin G seropositivity; neuromyelitis optica
• ISSN: 0972-2327; 1998-3549
• DOI: 10.4103/0972-2327.116945

Background: Neuromyelitis optica (NMO) is an immune-mediated inflammatory demyelinating disorder of the central nervous system with a predilection for the optic nerves and the spinal cord. Immunopathological evidence suggests that the target antigen of the disease is aquaporin-4. An IgG antibody against this protein has been explored as a molecular marker for the disease and as a diagnostic tool due to its high sensitivity and specificity in various populations. Objective: To assess the value of NMO-IgG testing in Indian patients with clinical and magnetic resonance imaging features consistent with NMO and longitudinally extensive transverse myelitis (LETM). Materials and Methods: Forty-five patients with clinical and magnetic resonance imaging features consistent with NMO, LETM, and MS were tested for serum NMO-IgG. Of these patients, 22 patients satisfied revised (2006) Wingerchuk criteria for NMO (excluding NMO-IgG status) and 11 patients had LETM. Twelve patients satisfied the revised (2010) McDonald criteria for multiple sclerosis (MS). Results: Of the 21 patients, satisfying the criteria for NMO and for whom the test results were available, 17 were positive for NMO-IgG (80.9%), and of the 11 patients having LETM, 6 (54.5%) were positive for NMO-IgG. In one patient with NMO, the test result was not available. None of the 12 patients satisfying McDonald criteria for MS showed NMO-IgG seropositivity. Conclusion: Our study suggests that it is worthwhile to pursue NMO-IgG testing as a diagnostic tool for patients with clinical and Magnetic Resonance Imaging (MRI) features consistent with NMO and LETM in the Indian population.