Effects of age and sex on aquaporin-4 autoimmunity

Amy M L Quek, Andrew B McKeon, Vanda A Lennon, Jayawant Mandrekar, Raffaele Iorio, Yujuan Jiao, Chiara Costanzi, Brian G Weinshenker, Dean Marko Wingerchuk, Claudia F Lucchinetti, Elizabeth A. Shuster, Sean J Pittock

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Abstract

Objective: To determine the sex and age distribution of aquaporin-4 (AQP4) autoimmunity using data derived from clinical service laboratory testing of 56 464 patient samples. Design : Observational analysis. Setting: Mayo Clinic Neuroimmunology Laboratory. Patients: Between October 1, 2005, and January 4, 2011, 56 464 patients were tested for AQP4-IgG; 2960 (5.2%) patients were seropositive. Main Outcome Measure : Seropositivity for AQP4- IgG. Results: Patients seropositive for AQP4-IgG were older than seronegative patients (mean [SD] age, 46 [16] vs 42 [15] years, respectively; P < .001). More females than males were tested (37 662 vs 16 810, respectively; P < .001). Among 2743 seropositive patients, 146 (5.3%) were pediatric (aged ≤18 years) and 333 (12.1%) were elderly (aged ≥65 years). The sex distribution of seropositive patients was 2465 females and 306 males (absolute female:male ratio, 8.1:1; P < .001). After adjusting for the number of females tested, an excess of females persisted (adjusted female:male ratio, 3.6:1). Female predominance for AQP4-IgG was more striking in adults (absolute female:male ratio, 8.4:1; adjusted female:male ratio, 3.5:1) than in pediatric patients (absolute female: male ratio, 4.3:1; adjusted female:male ratio, 2.9:1) (P < .001). Elderly women were more likely to be seropositive than individuals in other age categories (13.1% vs 6.0%, respectively; P < .001). The proportion of AQP4- IgG-seropositive individuals (detection rate), defined by decade of age, increased exponentially in women after age 50 years. Conclusions: Seropositivity for AQP4-IgG occurs predominantly in females, particularly in individuals older than 18 years. Among seropositive patients, 1 in 6 is in the extremes of age. The detection rate of AQP4-IgG increased in women after age 50 years.

Original languageEnglish (US)
Pages (from-to)1039-1043
Number of pages5
JournalArchives of Neurology
Volume69
Issue number8
DOIs
StatePublished - Aug 2012

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Aquaporin 4
Autoimmunity
Immunoglobulin G
Sex Distribution
Clinical Laboratory Services
Pediatrics
Age Distribution

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Effects of age and sex on aquaporin-4 autoimmunity. / Quek, Amy M L; McKeon, Andrew B; Lennon, Vanda A; Mandrekar, Jayawant; Iorio, Raffaele; Jiao, Yujuan; Costanzi, Chiara; Weinshenker, Brian G; Wingerchuk, Dean Marko; Lucchinetti, Claudia F; Shuster, Elizabeth A.; Pittock, Sean J.

In: Archives of Neurology, Vol. 69, No. 8, 08.2012, p. 1039-1043.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine the sex and age distribution of aquaporin-4 (AQP4) autoimmunity using data derived from clinical service laboratory testing of 56 464 patient samples. Design : Observational analysis. Setting: Mayo Clinic Neuroimmunology Laboratory. Patients: Between October 1, 2005, and January 4, 2011, 56 464 patients were tested for AQP4-IgG; 2960 (5.2{\%}) patients were seropositive. Main Outcome Measure : Seropositivity for AQP4- IgG. Results: Patients seropositive for AQP4-IgG were older than seronegative patients (mean [SD] age, 46 [16] vs 42 [15] years, respectively; P < .001). More females than males were tested (37 662 vs 16 810, respectively; P < .001). Among 2743 seropositive patients, 146 (5.3{\%}) were pediatric (aged ≤18 years) and 333 (12.1{\%}) were elderly (aged ≥65 years). The sex distribution of seropositive patients was 2465 females and 306 males (absolute female:male ratio, 8.1:1; P < .001). After adjusting for the number of females tested, an excess of females persisted (adjusted female:male ratio, 3.6:1). Female predominance for AQP4-IgG was more striking in adults (absolute female:male ratio, 8.4:1; adjusted female:male ratio, 3.5:1) than in pediatric patients (absolute female: male ratio, 4.3:1; adjusted female:male ratio, 2.9:1) (P < .001). Elderly women were more likely to be seropositive than individuals in other age categories (13.1{\%} vs 6.0{\%}, respectively; P < .001). The proportion of AQP4- IgG-seropositive individuals (detection rate), defined by decade of age, increased exponentially in women after age 50 years. Conclusions: Seropositivity for AQP4-IgG occurs predominantly in females, particularly in individuals older than 18 years. Among seropositive patients, 1 in 6 is in the extremes of age. The detection rate of AQP4-IgG increased in women after age 50 years.",
author = "Quek, {Amy M L} and McKeon, {Andrew B} and Lennon, {Vanda A} and Jayawant Mandrekar and Raffaele Iorio and Yujuan Jiao and Chiara Costanzi and Weinshenker, {Brian G} and Wingerchuk, {Dean Marko} and Lucchinetti, {Claudia F} and Shuster, {Elizabeth A.} and Pittock, {Sean J}",
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AU - Quek, Amy M L

AU - McKeon, Andrew B

AU - Lennon, Vanda A

AU - Mandrekar, Jayawant

AU - Iorio, Raffaele

AU - Jiao, Yujuan

AU - Costanzi, Chiara

AU - Weinshenker, Brian G

AU - Wingerchuk, Dean Marko

AU - Lucchinetti, Claudia F

AU - Shuster, Elizabeth A.

AU - Pittock, Sean J

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N2 - Objective: To determine the sex and age distribution of aquaporin-4 (AQP4) autoimmunity using data derived from clinical service laboratory testing of 56 464 patient samples. Design : Observational analysis. Setting: Mayo Clinic Neuroimmunology Laboratory. Patients: Between October 1, 2005, and January 4, 2011, 56 464 patients were tested for AQP4-IgG; 2960 (5.2%) patients were seropositive. Main Outcome Measure : Seropositivity for AQP4- IgG. Results: Patients seropositive for AQP4-IgG were older than seronegative patients (mean [SD] age, 46 [16] vs 42 [15] years, respectively; P < .001). More females than males were tested (37 662 vs 16 810, respectively; P < .001). Among 2743 seropositive patients, 146 (5.3%) were pediatric (aged ≤18 years) and 333 (12.1%) were elderly (aged ≥65 years). The sex distribution of seropositive patients was 2465 females and 306 males (absolute female:male ratio, 8.1:1; P < .001). After adjusting for the number of females tested, an excess of females persisted (adjusted female:male ratio, 3.6:1). Female predominance for AQP4-IgG was more striking in adults (absolute female:male ratio, 8.4:1; adjusted female:male ratio, 3.5:1) than in pediatric patients (absolute female: male ratio, 4.3:1; adjusted female:male ratio, 2.9:1) (P < .001). Elderly women were more likely to be seropositive than individuals in other age categories (13.1% vs 6.0%, respectively; P < .001). The proportion of AQP4- IgG-seropositive individuals (detection rate), defined by decade of age, increased exponentially in women after age 50 years. Conclusions: Seropositivity for AQP4-IgG occurs predominantly in females, particularly in individuals older than 18 years. Among seropositive patients, 1 in 6 is in the extremes of age. The detection rate of AQP4-IgG increased in women after age 50 years.

AB - Objective: To determine the sex and age distribution of aquaporin-4 (AQP4) autoimmunity using data derived from clinical service laboratory testing of 56 464 patient samples. Design : Observational analysis. Setting: Mayo Clinic Neuroimmunology Laboratory. Patients: Between October 1, 2005, and January 4, 2011, 56 464 patients were tested for AQP4-IgG; 2960 (5.2%) patients were seropositive. Main Outcome Measure : Seropositivity for AQP4- IgG. Results: Patients seropositive for AQP4-IgG were older than seronegative patients (mean [SD] age, 46 [16] vs 42 [15] years, respectively; P < .001). More females than males were tested (37 662 vs 16 810, respectively; P < .001). Among 2743 seropositive patients, 146 (5.3%) were pediatric (aged ≤18 years) and 333 (12.1%) were elderly (aged ≥65 years). The sex distribution of seropositive patients was 2465 females and 306 males (absolute female:male ratio, 8.1:1; P < .001). After adjusting for the number of females tested, an excess of females persisted (adjusted female:male ratio, 3.6:1). Female predominance for AQP4-IgG was more striking in adults (absolute female:male ratio, 8.4:1; adjusted female:male ratio, 3.5:1) than in pediatric patients (absolute female: male ratio, 4.3:1; adjusted female:male ratio, 2.9:1) (P < .001). Elderly women were more likely to be seropositive than individuals in other age categories (13.1% vs 6.0%, respectively; P < .001). The proportion of AQP4- IgG-seropositive individuals (detection rate), defined by decade of age, increased exponentially in women after age 50 years. Conclusions: Seropositivity for AQP4-IgG occurs predominantly in females, particularly in individuals older than 18 years. Among seropositive patients, 1 in 6 is in the extremes of age. The detection rate of AQP4-IgG increased in women after age 50 years.

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