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Neuromyelitis Optica (NMO) Spectrum Disorders

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https://www.readbyqxmd.com/read/29766684/neuromyelitis-optica-review-and-utility-of-testing-aquaporin-4-antibody-in-typical-optic-neuritis
#1
Meagan Seay, Janet C Rucker
Neuromyelitis optica (NMO) is an autoimmune, inflammatory demyelinating disorder often leading to severe vision impairment and disability. The discovery of a diagnostic biomarker, the aquaporin-4 antibody (AQP4-IgG), transformed the clinical diagnosis and treatment of NMO and broadened the spectrum of disease [NMO spectrum disorders (NMOSD)]. Though the antibody is highly sensitive and specific to NMOSD, routine testing in patients with typical optic neuritis is considered controversial. This article will provide a brief review of NMOSD and highlight the pros and cons of routine testing in typical optic neuritis...
May 16, 2018: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/29721683/pediatric-neuromyelitis-optica-spectrum-disorders
#2
REVIEW
Grace Y Gombolay, Tanuja Chitnis
PURPOSE OF REVIEW: Neuromyelitis optica spectrum disorders (NMOSDs) are a group of inflammatory and demyelinating disorders of the central nervous system that can occur in children and adults. The classic presentation of NMOSD is characterized by optic neuritis and transverse myelitis, but other presentations are also recognized, expanding the disease as NMO spectrum disorders. The purpose of this review is to discuss the clinical features, along with management and treatment options, including potential future therapeutic options, in pediatric NMOSD...
May 2, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29688841/dose-effects-of-mycophenolate-mofetil-in-chinese-patients-with-neuromyelitis-optica-spectrum-disorders-a-case-series-study
#3
Yujuan Jiao, Lei Cui, Weihe Zhang, Chunyu Zhang, Yeqiong Zhang, Xin Zhang, Jinsong Jiao
BACKGROUND: Neuromyelitis optica (NMO) spectrum disorder (NMOSD) is a devastating autoimmune inflammatory disorder of the central nervous system, which can result in blindness or paralysis. Currently, there is a dire need for new treatment options in the clinic. Several case series have shown that mycophenolate mofetil (MMF) may be an effective treatment for NMOSD patients. The dosing of MMF in the treatment of NMOSD has been poorly studied. Therefore, we evaluated the efficacy, tolerability, influential factors and optimal dosage of MMF in Chinese patients with NMOSD...
April 23, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29676204/neuromyelitis-optica-spectrum-disorder-mimicking-extensive-leukodystrophy
#4
Jonathan Ciron, Olivier Colin, Marie-Pierre Rosier, Soline Lapeyrie, Damien Biotti, David Brassat, Jean-Philippe Neau
Brain MRI was originally considered to appear normal in neuromyelitis optica spectrum disorders (NMO-SD). Typical brain lesions are now well described and have been integrated in the latest revision of NMO-SD criteria, but the NMO-SD MRI pattern remains not yet comprehensive. We report here extensive white matter lesions (EWML) mimicking leukodystrophy in a 50-year-old woman with long-lasting anti-AQP4+ NMO-SD. We suggest that EWML could be a possible brain MRI presentation of NMO-SD patients.
April 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29673575/classification-and-diagnostic-criteria-for-demyelinating-diseases-of-the-central-nervous-system-where-do-we-stand-today
#5
REVIEW
G Mathey, M Michaud, S Pittion-Vouyovitch, M Debouverie
The diagnosis of multiple sclerosis (MS) and other demyelinating diseases of the central nervous system is challenging, and although the currently available biological and imaging tools offer considerable support to physicians, these tools often fail to provide a simple and final answer at the time of a first event. Thus, sets of diagnostic criteria have been published and tested on patient cohorts, and are now used in clinical trials and in daily clinical practice. These criteria have evolved over time to take into account physicians' and patients' needs, along with emerging paraclinical tests...
April 16, 2018: Revue Neurologique
https://www.readbyqxmd.com/read/29623106/defining-distinct-features-of-anti-mog-antibody-associated-central-nervous-system-demyelination
#6
REVIEW
Martin S Weber, Tobias Derfuss, Imke Metz, Wolfgang Brück
Extensive research over the last decades basically failed to identify a common cause of noninfectious inflammatory central nervous system (CNS) demyelinating disease. To a great extent, this may reflect that the group of inflammatory CNS demyelinating disorders likely contains multiple pathogenetically distinct disease entities. Indeed, the greatest success so far in deciphering the pathogenesis of a CNS demyelinating disorder resulted from the discovery of anti-aquaporin (AQP)-4 antibodies (ab), which allowed progressive delineation of neuromyelitis optica (NMO), formerly considered a variant of the most common CNS demyelinating disorder, multiple sclerosis (MS), as a distinct disease...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29606320/recommendations-for-the-use-of-rituximab-in-neuromyelitis-optica-spectrum-disorders
#7
J Ciron, B Audoin, B Bourre, D Brassat, F Durand-Dubief, D Laplaud, E Maillart, C Papeix, S Vukusic, H Zephir, R Marignier, N Collongues
There is growing evidence of a preventive effect of Rituximab (RTX) in neuromyelitis optica spectrum disorders (NMO-SD). This monoclonal antibody against CD20 is becoming the most widely used preventive therapy in NMO-SD, as a first-line therapy or as a rescue therapy. Nevertheless, considerable heterogeneity still exists concerning the pre-treatment work-up, the vaccinations required before and under treatment, the number and dosage of infusions, prevention of the risk of infusion-related reactions, prevention of infections under treatment, and frequency of therapeutic cycles...
March 29, 2018: Revue Neurologique
https://www.readbyqxmd.com/read/29572032/chloride-imbalance-is-involved-in-the-pathogenesis-of-optic-neuritis-in-neuromyelitis-optica
#8
Tetsuya Akaishi, Toshiyuki Takahashi, Noriko Himori, Takayuki Takeshita, Toru Nakazawa, Masashi Aoki, Ichiro Nakashima
Chloride imbalance between the serum and the cerebrospinal fluid (CSF) has been recently shown to exist in the acute phase of neuromyelitis optica (NMO). In this report, we studied the relation between the quotient of chloride (QCl ) and the severity of optic neuritis (ON) in NMO patients. There was a positive correlation (R = 0.67; p < 0.05) between QCl and the length of ON-lesion. The visual prognosis also showed a positive correlation with QCl in the acute phase (R = 0.58; p < 0.05)...
March 16, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29515420/elderly-onset-neuromyelitis-optica-spectrum-disorder-with-pre-existing-prednisone-allergy
#9
Christopher Hollen, Omer Suhaib, Aaron Farrow, Evgeny Sidorov
We present a case of an 82-year-old man with new-onset neuromyelitis optica (NMO) spectrum disorder, the treatment of which was complicated by a severe pre-existing prednisone allergy. His age caused much initial doubt about his diagnosis, and his corticosteroid allergy altered our management as we attempted to minimize risk to the patient. Our patient was a healthy 82-year-old, right-handed man who presented with sensory loss of the bilateral lower extremities and progressive, painless vision loss. MRI showed bilateral pre-chiasmatic optic nerve and optic chiasm enhancement, along with enhancement within the thoracic spinal cord from T3 to T7...
January 2018: Case Reports in Neurology
https://www.readbyqxmd.com/read/29507012/sle-presenting-as-demyelinative-autoimmune-visual-loss
#10
Ami Schattner, Shilo Voichanski, Livnat Uliel
A healthy 38-year-old woman developed sudden unilateral vision loss due to retrobulbar optic neuritis in the wake of varicella-zoster virus infection. She had no further central nervous system (CNS) lesions. Antinuclear antibodies (ANA) and anti-aquaporin 4 antibodies were found, consistent with neuromyelitis optica (NMO). Later, serial MRIs showed dynamic short-segment and long-segment myelitis lesions, ANA titre increased and additional autoantibodies were found including anti-dsDNA, anti-chromatin/nucleosome and antiphospholipid antibodies...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29478727/a-comparison-of-pediatric-and-adult-neuromyelitis-optica-spectrum-disorders-a-review-of-clinical-manifestation-diagnosis-and-treatment
#11
REVIEW
Seyed Mohammad Baghbanian, Nasrin Asgari, Mohammad Ali Sahraian, Abdorreza Naser Moghadasi
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disorder of the central nervous system (CNS). Serum immunoglobulin G autoantibodies (NMO-IgG) are identified in the majority of NMOSD patients. The Pediatric form presents before 18 years. Based on the similarity of clinical, neuroimaging, and laboratory characteristics of pediatric NMOSD to those of the adult form, the international panel suggested that adult criteria of NMOSD also are appropriate in pediatric patients. However, the proposed criteria need validation in pediatric patients...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29433095/early-relapse-after-rtx-initiation-in-a-patient-with-nmo-ms-overlap-syndrome-how-long-to-conclude-to-a-failure-treatment
#12
Elisabeth Maillart, Anaïs Lippi, Catherine Lubetzki, Céline Louapre, Caroline Papeix
BACKGROUND: We report a dramatic clinical and radiological worsening within two months after rituximab initiation in a patient with NeuroMyelitis Optica/Multiple Sclerosis (NMO/MS) overlap syndrome. METHODS: Case study. RESULTS: A 45-year-old Caucasian woman with NMO/MS overlap syndrome experienced a severe myelitis nine weeks after first rituximab infusion, with extensive new gadolinium-enhanced spinal cord lesions. CONCLUSION: This case report illustrates the limits of MS and NMO-Spectrum Disorder classification and challenges the criteria of therapeutic failure within the 6 months after rituximab initiation...
February 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29428821/recombinant-igg1-fc-hexamers-block-cytotoxicity-and-pathological-changes-in-experimental-in-vitro-and-rat-models-of-neuromyelitis-optica
#13
Lukmanee Tradtrantip, Christian M Felix, Rolf Spirig, Adriana Baz Morelli, A S Verkman
Intravenous human immunoglobulin G (IVIG) may have therapeutic benefit in neuromyelitis optica spectrum disorders (herein called NMO), in part because of the anti-inflammatory properties of the IgG Fc region. Here, we evaluated recombinant Fc hexamers consisting of the IgM μ-tailpiece fused with the Fc region of human IgG1. In vitro, the Fc hexamers prevented cytotoxicity in aquaporin-4 (AQP4) expressing cells and in rat spinal cord slice cultures exposed to NMO anti-AQP4 autoantibody (AQP4-IgG) and complement, with >500-fold greater potency than IVIG or monomeric Fc fragments...
May 1, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29367170/application-of-the-2015-diagnostic-criteria-for-neuromyelitis-optica-spectrum-disorders-in-a-cohort-of-latin-american-patients
#14
E Carnero Contentti, I Soto de Castillo, V Daccach Marques, P A López, A Antunes Barreira, E Armas, C de Aquino Cruz, A Rubstein, C Lavigne Moreira, O M Molina, A Soto, V Tkachuk
BACKGROUND: The 2015 International Panel for neuromyelitis optica (NMO) spectrum disorders (NMOSD) diagnosis (IPND) criteria was recently proposed. However, because there are no studies evaluating application of the IPND criteria in Latin American populations, we aimed to assess whether these new criteria improve the diagnostic rate and reduce the time taken to make the diagnosis in a cohort of Latin American patients. METHODS: We reviewed medical records and applied both the 2006 and 2015 diagnostic criteria to all patients seen in four centers in Argentina, Brazil and Venezuela...
February 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29359475/incidence-of-neuromyelitis-optica-spectrum-disorder-in-the-central-denmark-region
#15
G H Dale, K B Svendsen, M C Gjelstrup, T Christensen, G Houen, E Nielsen, T Bek, T Petersen
OBJECTIVES: Neuromyelitis optica (NMO)/NMO spectrum disorder (NMOSD) may be misdiagnosed as multiple sclerosis. The aim of this study was to (i) to measure AQP4-IgG in patients who fulfilled the clinical and radiological criteria of NMOSD in the Central Denmark Region and (ii) to estimate the incidence of NMOSD in the region, according to both the 2006 Wingerchuk criteria and the 2015 International Panel for NMO Diagnosis criteria. MATERIALS AND METHODS: Medical records of all patients diagnosed with a demyelinating disorder in the region from 1 January 2012 to 31 December 2013 were reviewed...
January 22, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29349658/the-il-10-producing-regulatory-b-cells-b10-cells-and-regulatory-t-cell-subsets-in-neuromyelitis-optica-spectrum-disorder
#16
Eun Bin Cho, Hye-Jin Cho, Jin Myoung Seok, Ju-Hong Min, Eun-Suk Kang, Byoung Joon Kim
B cells contribute to the pathogenesis of neuromyelitis optica (NMO) by producing Aquaporin 4-specific autoantibodies (AQP4-ab); on the other hand, there are certain B cells that suppress immune responses by producing regulatory cytokines, such as IL-10. In this study, we investigated the presence of IL-10-producing Breg cells among lymphocyte subsets. Twenty-two seropositive NMO spectrum disorder (NMOSD) patients (29 samples) and 13 healthy controls (HCs) (14 samples) were enrolled. All NMOSD patients have received one or more immunosuppressive drugs...
March 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29339316/diagnosis-and-management-of-neuromyelitis-optica-spectrum-disorders-an-update
#17
REVIEW
Alice Bruscolini, Marta Sacchetti, Maurizio La Cava, Magda Gharbiya, Massimo Ralli, Alessandro Lambiase, Armando De Virgilio, Antonio Greco
Neuromyelitis optica (NMO) and Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune conditions characterized by inflammatory involvement of the optic nerve, spinal cord and central nervous system. Novel evidence showed a key role of autoantibodies against aquaporin-4 immunoglobulin G (AQP4 IgG) in the pathogenesis of NMOSD and, recently, new classification and diagnostic criteria have been adopted to facilitate an earlier identification and improve the management of these conditions. Diagnosis of NMOSD is currently based on clinical, neuroimaging and laboratory features...
March 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29320331/neuromyelitis-optica-spectrum-disorders-spectrum-of-mr-imaging-findings-and-their-differential-diagnosis
#18
Bruna Garbugio Dutra, Antônio José da Rocha, Renato Hoffmann Nunes, Antônio Carlos Martins Maia
Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder for which the aquaporin-4 (AQP4) water channels are the major target antigens. Advances in the understanding of NMO have clarified several points of its pathogenesis, clinical manifestations, and imaging patterns. A major advance was the discovery of the AQP4 antibody, which is highly specific for this disorder. Descriptions of new clinical and radiologic features in seropositive patients have expanded the spectrum of NMO, and the term NMO spectrum disorder (NMOSD) has been adopted...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29291482/paraneoplastic-neuromyelitis-optica-spectrum-disorder-a-single-center-cohort-description-with-two-cases-of-histological-validation
#19
Philippe Beauchemin, Raffaele Iorio, Anthony L Traboulsee, Thalia Field, Anna V Tinker, Robert L Carruthers
BACKGROUND: Paraneoplastic syndromes are remote effects of cancer caused by an autoimmune response triggered by tumor cells. Paraneoplastic Neuromyelitis Optica Spectrum Disorders (NMOSD) has been previously described, but the underlying mechanism for these rare cases is not well characterized. This paper presents a newly described case series of paraneoplastic NMOSD, including 2 new histological types of cancer and histological validation. METHODS: The UBC NMO clinic database was surveyed and identified 6 patients with paraneoplastic NMOSD...
February 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29246594/evaluation-of-the-retinal-nerve-fiber-layer-in-neuromyelitis-optica-spectrum-disorders-a-systematic-review-and-meta-analysis
#20
Anjiao Peng, Xiangmiao Qiu, Lin Zhang, Xi Zhu, Shixu He, Wanlin Lai, Lei Chen
BACKGROUND: An increasing number of studies have investigated the value of optical coherence tomography in patients with neuromyelitis optica (NMO) spectrum disorders; however, no systematic review has been performed to date. We aimed to systematically review and investigate the possibility of differentiating NMO and multiple sclerosis (MS) via an optical coherence tomography measurement. METHODS: Electronic databases, including MEDLINE, EMBASE and Web of Science, were systematically searched up to June 2017...
December 15, 2017: Journal of the Neurological Sciences
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