Arias-González NP, Valencia-Paredes D

Language: Spanish
References: 18
Page: 58-61
PDF size: 526.00 Kb.

ABSTRACT

Neuromyelitis optica is an autoimmune disease involving the spinal cord and the optic nerve, having clinical symptoms of optic neuritis, blindness, ocular pain, symptoms of radicular pain, paraplegia, spasms and neurological disorders. Initially believed to be part of multiple sclerosis, however, it has been found to belong to a separate entity and to have the particular feature of anti-aquaporin 4 antibodies (NMO -IgG). Aquaporin 4 channels are present in astrocytes and are target of activation of the immune system, which is mainly mediated by T and B lymphocytes and the complement system. The diagnostic is based on the criteria published in 2006 by Wingerchuk; modified from the same criteria published in the year 1999. The presence of two of the three criteria is enough to match the diagnosis to neuromyelitis optica including: the presence of vertebral lesions demonstrated by MRI, the presence of aquaporin-4 antibodies and exclusion of multiple sclerosis diagnosis. Treatment for these patients is based on the use of immunomodulators and immunosuppressants. Despite of diagnostic and treatment advances, neuromyelitis optica is a disease with poor response to treatment and a poor prognostic in most cases.

REFERENCES

1. Oh J. Neuromyelitis Optica: An Antibody-Mediated Disorder of the Central Nervous System. Neurology Research International 2012; 30: 1-13.

2. Tait J. Water movements in the brain: role of aquaporins. Trends of Neurosciences 2008; 31(1): 37- 43.

3. Asgari N. Epidemiological, clinical and immunological aspects of neuromyelitis optica. Danish Medical Journal 2012; 26: 1-19.

4. Pisani F. Aquaporin-4 Autoantibodies in Neuromyelitis Optica: AQP4 Isoform-Dependent Sensitivity and Specificity. PLOS ONE 2013; 8(11): 1- 11.

5. Lucchinetti C. Optica, The Pathology of an Autoimmune Astrocytopathy: Lessons Learned from Neuromyelitis. International Society of Neuropathology 2014; 10-25.

6. Kolfenbach J. Neuromyelitis Optica Spectrum Disorder in Patients With Connective Tissue Disease and Myelitis. Arthritis Care & Research 2011; 63(08) :1203-1208.

7. Papadopoulos M. Aquaporin 4 and neuromyelitis optica. The Lancet 2012; 11(06): 535-544.

8. Paul F. Hope for a rare disease: eculizumab in neuromyelitis optica. Lancet Neurology 2013; 12(06): 529-531.

9. Wingerchuk D. The spectrum of neuromyelitis optica. Lancet Neurology 2008; 06(09): 805-815.

10. 10.Okada H. Neuromyelitis Optica Preceded by HypercKemia and a Possible Association with coxsackie Virus Group A10 Infection. Internal Medicine 2013; 1-4.

11. 11.Wingerchuk D. The clinical course of neuromyelitis optica. Neurology 1999; 53(13): 1107-1119.

12. 12.Lennon V. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. The Lancet 2004; 364: 2106-21012.

13. 13.Matthews L. The role of imaging in diagnosing neuromyelitis optica spectrum disorder. Multiple Sclerosis and Related Disorders 2013; 15: 115-125.

14. 14.Uzawa A. Neuromyelitis optica: Concept, immunology and treatment. Journal of Clinical Neuroscience 2014; 12: 12-21.

15. 15.Wingerchuk D. Revised diagnostic criteria for neuromyelitis optica. Neurology 2006; 66(10): 1485- 1490.

16. 16.Drori T. Diagnosis and classification of neuromyelitis optica. Autoimmunity Reviews 2014; 15(e.g. 2): 135-155.

17. 17.Kimbrough D. Treatment of neuromyelitis optica: Review and recommendations. Multiple Sclerosis and Related Disorders 2012; 1: 180-187.

18. 18.Bienia B. Immunotherapy of Neuromyelitis Optica. Autoimmune diseases 2013; 10: 125-135.