Neuromyelitis optica and non-organ-specific autoimmunity

Sean J. Pittock, Vanda A. Lennon, Jerome De Seze, Patrick Vermersch, Henry A. Homburger, Dean M. Wingerchuk, Claudia F. Lucchinetti, Hélène Zéphir, Kevin Moder, Brian G. Weinshenker

Research output: Contribution to journalArticle

409 Scopus citations

Abstract

Background: Neuromyelitis optica (NMO) is often associated with other clinical or serological markers of non-organ-specific autoimmunity. Objective: To evaluate the relationship between NMO spectrum disorders (NMOSDs), including NMO, longitudinally extensive transverse myelitis, and recurrent optic neuritis, and autoimmune disease. We concentrated on the association with systemic lupus erythematosus (SLE), Sjögren syndrome(SS),or serological evidence of these disorders, which commonly is a source of diagnostic confusion. Design: Retrospective blinded serological survey. Setting: Mayo Clinic College of Medicine, Rochester, and Centre Hospitalier Régional Universitaire de Lille. Methods: Group 1 included 153 US patients with NMOSDs (78 with NMO and 75 with longitudinally extensive transverse myelitis) and 33 control subjects with SS/SLE. Group 2 included 30 French patients with SS/SLE, 14 with NMOSDs (6 with NMO, 6 with longitudinally extensive transverse myelitis, and 2 with recurrent optic neuritis), 16 without NMOSDs, and 4 with NMO without SS/SLE. Results: For group 1, NMO-IgG was detected in 66.7%, antinuclear antibodies in 43.8%, and Sjögren syndrome A (SSA) antibodies in 15.7% of patients with NMO and longitudinally extensive transverse myelitis. Five NMO-IgG-seropositive patients with NMOSDs had coexisting SLE, SS, or both. Antinuclear antibodies and SSA antibodies were more frequent in NMO-IgG-seropositive patients than in NMO-IgG-seronegative patients (P=.001). For group 2, NMO-IgG was detected in 5 of 14 patients (35.7%) with NMOSDs and SS/SLE and in 2 of 4 patients (50.0%) with NMO without SS/SLE (P=.59). We detected NMO-IgG only in patients with NMOSDs and not in 49 controls with SS/SLE but without optic neuritis or myelitis from the 2 cohorts (P=.01). Conclusion: Neuromyelitis optica spectrum disorders with seropositive findings for NMO-IgG occurring with SS/SLE or non-organ-specific autoantibodies is an indication of coexisting NMO rather than a vasculopathic or other complication of SS/SLE.

Original languageEnglish (US)
Pages (from-to)78-83
Number of pages6
JournalArchives of neurology
Volume65
Issue number1
DOIs
StatePublished - Jan 2008

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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