Revised diagnostic criteria for neuromyelitis optica (NMO). Application in a series of suspected patients.
We analyzed neuromyelitis optica (NMO) IgG in the serum or CSF samples from 46 patients with suspected NMO (28) and limited forms of NMO (18). One hundred and fifteen samples from multiple sclerosis (MS) patients were included as controls. The final clinical diagnosis after follow-up was 16 NMO, 12 MS, 11 transverse myelitis (TM) and seven recurrent optic neuritis (RON). NMO-IgG was detected in 62.5% of NMO, 50% of the recurrent longitudinally extensive TM, 14.3% of the RON but in none of the MS patients. The authors then compared the newly revised diagnostic criteria for NMO with the criteria published in 1999, in the 28 patients with suspected NMO. The revised criteria had higher specificity, and positive and negative predictive value (83.3% vs. 25%; 87.5% vs. 62.5; 83.3% vs. 75%), but slightly lower sensitivity (87.5% vs. 93.7%). Our study confirms NMO-IgG as a highly specific marker of NMO, and the usefulness of the revised diagnostic criteria in predicting a diagnosis of NMO.
Saiz
Albert
A
Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, Barcelona, 08036 Spain. asaiz@clinic.ub.es
Zuliani
Luigi
L
Blanco
Yolanda
Y
Tavolato
Bruno
B
Giometto
Bruno
B
Graus
Francesc
F
D000328:Adult; D017668:Age of Onset; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D009471:Neuromyelitis Optica / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D009902:Optic Neuritis / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D011237:Predictive Value of Tests; D012008:Recurrence
D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers; D007074:Immunoglobulin G