Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis.
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).


CONCLUSIONS
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.
Weinshenker
Brian G
BG
Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. weinb@mayo.edu
Wingerchuk
Dean M
DM
Vukusic
Sandra
S
Linbo
Linda
L
Pittock
Sean J
SJ
Lucchinetti
Claudia F
CF
Lennon
Vanda A
VA
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000134:cerebrospinal fluid / Q000150:complications* / Q000473:pathology; D009471:Neuromyelitis Optica / Q000097:blood / Q000276:immunology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012698:Serologic Tests / Q000379:methods; D018709:Statistics, Nonparametric
D015415:Biomarkers; D007074:Immunoglobulin G