title: Neuromyelitis optica in Japanese sisters.
abstract: We report cases of Japanese sisters with neuromyelitis optica (NMO). The elder sister was 25, when she was diagnosed with right optic neuritis. After 3 months, she developed left optic neuritis and myelitis. At age 27, she had the second relapse, but she has been free from episodes thereafter. The younger sister was 26, when she was diagnosed with optic neuritis. Thus far, she has 9 relapses, comprising both myelitis and optic neuritis. Both sisters had normal brain MRI scans, longitudinally extensive transverse myelitis over 3 vertebral segments, and positive results for anti-aquaporin-4 antibody (AQAP4Ab). They fulfilled the Wingerchuk criteria for definite NMO. Both sisters shared some immunogenetic factors, but they were not exposed to the same environmental factors after their early twenties. The final disability status was almost the same in both cases, and both showed a very benign course. These data suggest that genetic factors affect the age at onset and environmental factors may affect the frequency of relapse.
authors.affiliation: Department of Neurology and Geriatrics, Graduate School of Medicine, Gifu University, Japan. yutanaka-gif@umin.net
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Yoshikura
authors.forename: Naoko
authors.initials: N
authors.lastname: Harada
authors.forename: Megumi
authors.initials: M
authors.lastname: Yamada
authors.forename: Akihiro
authors.initials: A
authors.lastname: Koumura
authors.forename: Takeo
authors.initials: T
authors.lastname: Sakurai
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.forename: Isao
authors.initials: I
authors.lastname: Hozumi
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Inuzuka
mesh_terms: D000328:Adult; D017668:Age of Onset; D044466:Asian People / Q000235:genetics; D004185:Disability Evaluation; D005260:Female; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000175:diagnosis / Q000209:etiology / Q000235:genetics* / Q000503:physiopathology; D012008:Recurrence; D035781:Siblings; D013116:Spinal Cord / Q000473:pathology; D013997:Time Factors
chemical_list: D006680:HLA Antigens