title: Value of NMO-IgG determination at the time of presentation as CIS.
abstract: BACKGROUND
  Despite the availability of diagnostic criteria, an overlap between neuromyelitis optica (NMO) and multiple sclerosis (MS) exists, particularly in the early stage of the disease.
  
  
  OBJECTIVE
  To study the value of NMO-immunoglobulin G (IgG) determination in Caucasian patients with a first demyelinating episode who develop a relapsing form of optic neuritis or myelitis.
  
  
  METHODS
  This study was based on a prospectively acquired cohort of patients regarded as having a clinically isolated syndrome (CIS) at the time of presentation. From this cohort, 2 different groups were selected: group 1 (NMO phenotype), consisting of a first attack involving the optic nerve or the spinal cord, and at least a second event affecting either topography, and group 2 (negative control group), consisting of a first attack involving the brainstem or the cerebral hemispheres and at least 1 relapse in any topography. Group 3 was composed of patients with NMO according to the 2006 revised diagnostic criteria. Serum NMO-IgG was determined by indirect immunofluorescence.
  
  
  RESULTS
  A total of 3.1 of the group 1 patients were positive for NMO-IgG in comparison to 3.9% of group 2 and 44.5% of group 3, NMO. One of the positive patients in group 1 evolved to NMO.
  
  
  CONCLUSIONS
  NMO-IgG determination is crucial in detecting patients who will develop NMO; however, its value as a routine test in cases presenting with symptoms of the type seen in MS is low, and should only be performed in those patients in which the initial diagnosis is not clear.
authors.affiliation: Unitat de Neuroimmunologia Clinica (UNiC), Centre d’Esclerosi Mu´ltiple de Catalunya, Vall d’Hebron Institut de Recerca, Barcelona, Spain. carme.costa@vhir.org
authors.forename: C
authors.initials: C
authors.lastname: Costa
authors.forename: G
authors.initials: G
authors.lastname: Arrambide
authors.forename: M
authors.initials: M
authors.lastname: Tintore
authors.forename: J
authors.initials: J
authors.lastname: Castilló
authors.forename: J
authors.initials: J
authors.lastname: Sastre-Garriga
authors.forename: C
authors.initials: C
authors.lastname: Tur
authors.forename: J
authors.initials: J
authors.lastname: Río
authors.forename: A
authors.initials: A
authors.lastname: Saiz
authors.forename: A
authors.initials: A
authors.lastname: Vidal-Jordana
authors.forename: C
authors.initials: C
authors.lastname: Auger
authors.forename: C
authors.initials: C
authors.lastname: Nos
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: M
authors.initials: M
authors.lastname: Comabella
authors.forename: A
authors.initials: A
authors.lastname: Horga
authors.forename: X
authors.initials: X
authors.lastname: Montalban
mesh_terms: D000293:Adolescent; D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology*; D015331:Cohort Studies; D003711:Demyelinating Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D043025:Oligoclonal Bands / Q000097:blood* / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies; D013997:Time Factors; D044465:White People; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D043025:Oligoclonal Bands