title: Serological markers associated with neuromyelitis optica spectrum disorders in South India.
abstract: BACKGROUND
  Neuromyelitis optica spectrum disorders (NMOSDs) represent 20% of all demyelinating disorders in South India. No studies have determined the seroprevalence to both antibodies against aquaporin-4* and antimyelin oligodendrocyte glycoprotein antibody (anti-MOG+) in this population.
  
  
  OBJECTIVE
  To identify and characterize seropositive patients for anti-aquaporin-4 antibody (anti-AQP4+) and anti-MOG+ in South India.
  
  
  METHODS
  We included 125 consecutive patients (15 children) who were serologically characterized using live transfected cells to human M23-AQP4 or full-length MOG.
  
  
  RESULTS
  Among a total of 125 patients, 30.4% of patients were anti-AQP4+, 20% were anti-MOG+, and 49.6% were seronegative. No patient was positive for both. Anti-MOG+ patients represented 28.7% (25/87) of seronegative NMOSD. In comparison to anti-AQP4+ patients, anti-MOG+ patients were commonly male, had less frequent attacks and milder disability on expanded disability status score scale. Seronegative patients were also predominantly male, 36% (9/25) had monophasic longitudinally extensive transverse myelitis and disability was comparable with anti-AQP4+ patients. Lumbar cord involvement was common in anti-MOG+ and seronegatives, whereas anti-AQP4+ patients had more cervical lesions.
  
  
  CONCLUSIONS
  Anti-AQP4+/anti-MOG + patients accounted for nearly half of the patients suspected of having NMOSD in South India, indicating that antibody testing may be useful on the management of subgroups with different prognosis.
authors.affiliation: Department of Neurology, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India.
authors.forename: Lekha
authors.initials: L
authors.lastname: Pandit
authors.affiliation: Department of Neurology and Multiple Sclerosis Therapeutics, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Neurology, Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Douglas Kazutoshi
authors.initials: DK
authors.lastname: Sato
authors.affiliation: Department of Neurology, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India.
authors.forename: Sharik
authors.initials: S
authors.lastname: Mustafa
authors.affiliation: Department of Neurology, Yonezawa National Hospital, Yonezawa, Yamagata, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Neurology, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India.
authors.forename: Anitha
authors.initials: A
authors.lastname: D'Cunha
authors.affiliation: Department of Neurology, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India.
authors.forename: Chaithra
authors.initials: C
authors.lastname: Malli
authors.affiliation: Department of Neurology, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India.
authors.forename: Akshatha
authors.initials: A
authors.lastname: Sudhir
authors.affiliation: Department of Neurology and Multiple Sclerosis Therapeutics, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fujihara
keywords: Antibody; India; aquaporin-4; myelin oligodendrocyte glycoprotein; neuromyelitis optica