Document Detail

Diagnostic utility of NMO/AQP4-IgG in evaluating CNS inflammatory disease in Thai patients.
MedLine Citation:
PMID:  22831763     Owner:  NLM     Status:  MEDLINE    
Epidemiological studies in Thailand have reported that inflammatory demyelinating diseases (IDDs) commonly affect the optic nerve and spinal cord. We investigated the diagnostic utility of aquaporin (AQP)-4-IgG testing in 31 consecutive patients evaluated for CNS IDDs in 3 academic Thai hospital neurology clinics between February 2008 and January 2009. Patients were classified into 3 clinical diagnostic groups: Neuromyelitis optica (NMO, n=10) multiple sclerosis (MS, n=5) and unclassified IDD (n=16). All sera were tested blindly by cell binding (Euroimmun) assay (CBA). Sera were also tested by indirect immunofluorescence assay (IFA) and ELISA (RSR/Kronus). After initial screening by CBA, AQP4-IgG was detected in 6 NMO patients (60%); 3 of the 4 seronegative cases were receiving immunosuppressants. AQP4-IgG was detected in 13 unclassified IDD cases (81%), but in no MS cases. Cell binding assay and ELISA were more sensitive than IFA (p=0.0004). The 81% seropositivity rate in "unclassified" patients suggests that AQP4 autoimmunity accounts for a significant proportion of Thai CNS inflammatory demyelinating disease, especially those with optic neuritis or transverse myelitis, with or without abnormal brain MRI, in whom a specific diagnosis or clear-cut treatment approach is unclear.
Metha Apiwattanakul; Thanin Asawavichienjinda; Teeratorn Pulkes; Tasanee Tantirittisak; Thiravat Hemachudha; Erika S Horta; Sarah M Jenkins; Sean J Pittock
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-07-24
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  320     ISSN:  1878-5883     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-08     Completed Date:  2013-01-14     Revised Date:  2013-09-18    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  118-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier B.V. All rights reserved.
Department of Neurology, Prasat Neurological Institute, Bangkok, Thailand.
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MeSH Terms
Aquaporin 4 / blood,  diagnostic use*
Asian Continental Ancestry Group / statistics & numerical data*
Autoantibodies / blood,  diagnostic use
Demyelinating Autoimmune Diseases, CNS / blood,  diagnosis*
Immunoglobulin G / blood,  diagnostic use*
Middle Aged
Multiple Sclerosis / blood,  diagnosis
Neuromyelitis Optica / blood,  diagnosis
Predictive Value of Tests
Grant Support
Reg. No./Substance:
0/Aquaporin 4; 0/Autoantibodies; 0/Immunoglobulin G

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