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Published on: August 21, 2017
Distinct clinical patterns in AQP4-IgG- positive NMOSD patients vs. Seronegative: Insights from a single-center study
Andrés M Villa1, Analisa Manin1, Carla Seimandi1
1División Neurología. Hospital Gral. de Agudos Dr. José María Ramos Mejía, Bs. As, Argentina; Centro Argentino de Neuroinmunología (CADENI). Facultad de Medicina, Universidad de Buenos Aires. Argentina.
Background:
Distinct clinical course patterns have been identified between AQP4-IgG-positive and AQP4-IgG-negative NMOSD patients.
Objectives:
This study aimed to evaluate the differences between AQP4-IgG-seropositive and AQP4-IgG-seronegative NMOSD patients in a single centre in Argentina.
Methods:
We performed a retrospective cross-sectional study of 108 NMOSD patients in the city of Buenos Aires, Argentina.
Results:
We selected 94 for analysis. 77 patients (82 %) were AQP4-IgG positive. In the AQP4-IgG positive group, the ratio of male to female was 1:10 vs. 1:1.2 in the seronegative group (p = 0.001). Relapses were observed in 76 out of 77 (99 %) AQP4-IgG positive patients versus 3 out of 17 (17.6 %) AQP4-IgG negative patients (p = 0.01). In the seropositive group, other autoimmune diseases were present in 34/77 patients (44 %) vs. 2/12 (12 %) in the seronegative patients, a statistically significant difference (p = 0.009). 81 % of the seropositive group had an early adulthood onset (EAO-NMOSD) compared to 35 % in the seronegative group. All AQP4+ patients positive received treatment with monoclonal antibodies. In AQP4-IgG- NMOSD patients the use of immunosuppressive treatment was more common.
Conclusion:
Female predominance, EAO-NMOSD, recurrence course and a high prevalence of autoimmune disease in AQP4-IgG-positive patients demonstrated a more pronounced autoimmunity profile.
Insights
Aquaporin-4 immunoglobulin G (AQP4-IgG) positive Neuromyelitis Optica Spectrum Disorder (NMOSD) patients show distinct clinical patterns. AQP4-IgG-positive NMOSD patients exhibit greater female predominance, early adulthood onset, and a higher prevalence of other autoimmune diseases.
Area of Science:
- Neurology
- Immunology
- Autoimmune Diseases
Background:
- Neuromyelitis Optica Spectrum Disorder (NMOSD) exhibits distinct clinical courses based on Aquaporin-4 immunoglobulin G (AQP4-IgG) serostatus.
- Understanding these differences is crucial for accurate diagnosis and management of NMOSD.
Purpose of the Study:
- To evaluate and compare clinical characteristics between AQP4-IgG-seropositive and AQP4-IgG-seronegative NMOSD patients.
- To identify specific demographic, clinical, and immunological differences in a single center in Argentina.
Main Methods:
- A retrospective cross-sectional study was conducted involving 108 NMOSD patients in Buenos Aires, Argentina.
- Data from 94 patients were analyzed, focusing on AQP4-IgG status, demographics, clinical course, and co-existing autoimmune diseases.
Main Results:
- Of 94 analyzed patients, 77 (82%) were AQP4-IgG positive.
- AQP4-IgG-positive patients showed a significantly higher female-to-male ratio (1:10 vs. 1:1.2), higher relapse rates (99% vs. 17.6%), and a greater prevalence of other autoimmune diseases (44% vs. 12%).
- Early adulthood onset (EAO-NMOSD) was more common in the seropositive group (81% vs. 35%).
Conclusions:
- AQP4-IgG-positive NMOSD patients present with a more pronounced autoimmune profile, characterized by female predominance, early adulthood onset, recurrent disease courses, and a high comorbidity with other autoimmune conditions.
- These findings highlight the importance of AQP4-IgG testing for stratifying NMOSD patients and tailoring treatment strategies.
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