title: Recurrent neuromyelitis optica in Brazilian patients: clinical, immunological, and neuroimaging characteristics.
abstract: Neuromyelitis optica has not been thoroughly studied in Brazilian patients following the discovery of NMO-IgG and its specific antigen aquaporin-4. In this study we aimed to describe the clinical NMO-IgG immunological status and neuroimaging characteristics of recurrent neuromyelitis optica in a series Brazilian patients. We undertook a retrospective study of 28 patients with recurrent neuromyelitis optica, according to 1999 Wingerchuk's diagnostic criteria. Data on NMO-IgG status, clinical features, and MRI findings were analyzed. Three men and 25 women were evaluated. Median age at onset of disease was 26 years (range 7-55); median time of follow-up was 7 years (range 2-14). The mean time elapsed between the first and the second attack was 17 months (median 8.5; range 2-88). NMO-IgG was detected in 18 patients (64.3%). Four patients died due to respiratory failure. Most patients presented with cervical (36%) and cervical-thoracic myelitis (46.4%). Holocord lesion was the most common pattern of involvement (50%) on the axial plane. We did not find a statistical association between myelitis extension and NMO-IgG result. Our series of Brazilian patients showed a younger age of onset than previously reported. In our series, in contrast to previous reports, there was no correlation between the extension of myelitis and NMO-IgG positivity.
authors.affiliation: Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil. tarsoadoni@usp.br
authors.forename: T
authors.initials: T
authors.lastname: Adoni
authors.forename: A M M
authors.initials: AM
authors.lastname: Lino
authors.forename: P D
authors.initials: PD
authors.lastname: da Gama
authors.forename: S L
authors.initials: SL
authors.lastname: Apóstolos-Pereira
authors.forename: P E
authors.initials: PE
authors.lastname: Marchiori
authors.forename: F
authors.initials: F
authors.lastname: Kok
authors.forename: D
authors.initials: D
authors.lastname: Callegaro
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001921:Brain / Q000473:pathology; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D012008:Recurrence; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G