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Neuromyelitis Optica and Neuromyelitis Optica Spectrum Disorders : Report of Nine Cases

Year 2016, Volume: 11 Issue: 3, 17 - 22, 24.03.2018

Abstract



Objective: We aimed to report our nine
Neuromyelitis Optica (NMO) and NMO Spectrum Disorders (NMOSD) cases which have
different presentations.
 



 



Patients and Methods: In this observational
retrospective study, conducted between September 2011 and September
2015 in Antalya Education
and Research Hospital Neurology Department, we enrolled 9 patients who were
diagnosed as NMO/NMOSD.



 



Results: We had 9 patients (8 female,
1 male). The mean age at onset was 49 years (36-67). While 7 patients were
diagnosed with NMO, 2 patients’ diagnoses were NMOSD. The Case 6 was admitted
to our clinic with an LETM (longitudinally extensive transverse myelitis)
attack after 4 months of chemotherapy and radiotherapy treatment for
gallbladder adenocancer. The Case 8 experienced LETM after the diagnosis of
pulmonary tuberculosis and under anti-tuberculosis treatment, and the Case 9
was presented with LETM after post-vaccination. Optic nerve and spinal cord
involvement occurred simultaneously in three patients. In three cases, optic
neuritis developed 4 months, 15 months and 5 years after the myelitis attack. The
Case 7 was referred to the hospital owing to cranial involvement, following a
history of optic neuritis attacks six months earlier.
  The Case 1 had three recurrent optic neuritis
attacks before the last attack of admission which included brain stem involvement
and LETM. The Case 4 was receiving low dose interferone beta-1a with diagnosis
of MS. NMO-IgG seropositivity was detected in 6 patients.



 



Conclusion: Most of our patients were
female and have relapsing course. Patients who experienced relapses, mostly
were seropositive for NMO- IgG.



 



References

  • 1. Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology 2006; 66: 1485–9.
  • 2. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol. 2007; 6: 805- 15.
  • 3. Sellner J, Boggild M, Clanet M, Hintzen RQ, Illes Z, Montalban X, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol 2010; 17: 1019–32.
  • 4. Sahraian MA, Radue EW, Minagar A. Neuromyelitis Optica Clinical Manifestations and Neuroimaging Features. Neurol Clin 2013; 31: 139–152
  • 5. Pittock SJ, Lennon VA, Krecke K, Wingerchuk DM, Lucchinetti CF, Weinshenker BG. Brain abnormalities in neuromyelitis optica. Arch Neurol 2006; 63: 390–6.
  • 6. Cabrera-Gomez JA, Kister I. Conventional brain MRI in neuromyelitis optica. Eur J Neurol 2012; 19: 812–9.
  • 7. Dietemann JL, Beigelman C, Rumbach L, Vouge M, Tajahmady T, Faubert C, et al. Multiple sclerosis and corpus callosum atrophy: relationship of MRI findings to clinical data. Neuroradiology 1988; 30: 478–80
  • 8. Klawiter EC, Ceccarelli A, Arora A, Jackson J, Bakshi S, Kim G, et al. Corpus Callosum atrophy correlates with gray matter atrophy in patients with multiple sclerosis. J Neuroimaging. 2015; 25: 62-7
  • 9. Lu Z, Zhang B, Qiu W, Kang Z, Shen L, Long Y, et al. Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis. PLoS One. 2011; 6: e22766.
  • 10. Mandler RN. Neuromyelitis optica - Devic’s syndrome, update. Autoimmun Rev 2006; 5: 537–43.
  • Wingerchuk DM, Hogancamp WF, O’Brien PC, Weinshenker BG. The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 1999; 53: 1107–14.
  • 12. O’Riordan JI, Gallagher HL, Thompson AJ, Howard RS, Kingsley DP, Thompson EJ, et al. Clinical, CSF, and MRI findings in Devic’s neuromyelitis optica. J Neurol Neurosurg Psychiatry 1996; 60: 382–7.
  • 13. Jarius S, Paul F, Franciotta D, Ruprecht K, Ringelstein M, Bergamaschi R, et al. Cerebrospinal fluid findings in aquaporin- 4 antibody positive neuromyelitis optica: results from 211 lumbar punctures. J Neurol Sci. 2011; 306: 82–90
  • 14. Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 2004; 364: 2106–12.
  • 15. Pittock SJ, Lennon VA, de Seze J, Vermersch P, Homburger HA, Wingerchuk DM, et al. Neuromyelitis optica and non organ-specific autoimmunity. Arch Neurol 2008; 65: 78- 83.
  • 16. McKeon A, Lennon VA, Jacob A, Matiello M, Lucchinetti CF, Kale N, et al. Coexistence of myasthenia gravis and serological markers of neurological autoimmunity in neuromyelitis optica. Muscle Nerve. 2009; 39: 87- 90.
  • 17. Bergamaschi R, Jarius S, Robotti M, Pichiecchio A, Wildemann B, Meola G. Two cases of benign neuromyelitis optica in patients with celiac disease. J Neurol, 2009; 256: 2097–99.
  • 18. Jacob A, Matiello M, Wingerchuk DM, Lucchinetti CF, Pittock SJ, Weinshenker BG. Neuromyelitis optica: changing concepts. J Neuroimmunol 2007; 187: 126–38.
  • 19. Weinshenker BG, Wingerchuk DM, Vukusic S, Linbo L, Pittock SJ, Lucchinetti CF, et al. Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis. Ann Neurol 2006; 59: 566–9.
  • 20. Pittock SJ, Lennon VA. Aquaporin-4 autoantibodies in a paraneoplastic context. Arch Neurol. 2008; 65: 629–632.
  • 21. Jarius S, Ruprecht K, Wildemann B, Kuempfel T, Ringelstein M, Geis C Kleiter I, et al. Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: A multicentre study of 175 patients. J Neuroinflammation. 2012; 9: 14.
  • 22. Zatjirua V, Butler J, Carr J, Henning F. Neuromyelitis optica and pulmonary tuberculosis: a case-control study Int J Tuberc Lung Dis. 2011; 15:1675- 80.
  • 23. Sahu SK, Giri S, Gupta N. Longitudinal extensive transverse myelitis due to tuberculosis: a report of four cases. J Postgrad Med. 2014; 60: 409-12.
  • 24. Trebst C, Jarius S, Berthele A, Paul F, Schippling S, Wildemann B, et al. Update on the diagnosis and treatment of neuromyelitis optica: recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol 2014; 261:1- 16.
Year 2016, Volume: 11 Issue: 3, 17 - 22, 24.03.2018

Abstract

References

  • 1. Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology 2006; 66: 1485–9.
  • 2. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol. 2007; 6: 805- 15.
  • 3. Sellner J, Boggild M, Clanet M, Hintzen RQ, Illes Z, Montalban X, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol 2010; 17: 1019–32.
  • 4. Sahraian MA, Radue EW, Minagar A. Neuromyelitis Optica Clinical Manifestations and Neuroimaging Features. Neurol Clin 2013; 31: 139–152
  • 5. Pittock SJ, Lennon VA, Krecke K, Wingerchuk DM, Lucchinetti CF, Weinshenker BG. Brain abnormalities in neuromyelitis optica. Arch Neurol 2006; 63: 390–6.
  • 6. Cabrera-Gomez JA, Kister I. Conventional brain MRI in neuromyelitis optica. Eur J Neurol 2012; 19: 812–9.
  • 7. Dietemann JL, Beigelman C, Rumbach L, Vouge M, Tajahmady T, Faubert C, et al. Multiple sclerosis and corpus callosum atrophy: relationship of MRI findings to clinical data. Neuroradiology 1988; 30: 478–80
  • 8. Klawiter EC, Ceccarelli A, Arora A, Jackson J, Bakshi S, Kim G, et al. Corpus Callosum atrophy correlates with gray matter atrophy in patients with multiple sclerosis. J Neuroimaging. 2015; 25: 62-7
  • 9. Lu Z, Zhang B, Qiu W, Kang Z, Shen L, Long Y, et al. Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis. PLoS One. 2011; 6: e22766.
  • 10. Mandler RN. Neuromyelitis optica - Devic’s syndrome, update. Autoimmun Rev 2006; 5: 537–43.
  • Wingerchuk DM, Hogancamp WF, O’Brien PC, Weinshenker BG. The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 1999; 53: 1107–14.
  • 12. O’Riordan JI, Gallagher HL, Thompson AJ, Howard RS, Kingsley DP, Thompson EJ, et al. Clinical, CSF, and MRI findings in Devic’s neuromyelitis optica. J Neurol Neurosurg Psychiatry 1996; 60: 382–7.
  • 13. Jarius S, Paul F, Franciotta D, Ruprecht K, Ringelstein M, Bergamaschi R, et al. Cerebrospinal fluid findings in aquaporin- 4 antibody positive neuromyelitis optica: results from 211 lumbar punctures. J Neurol Sci. 2011; 306: 82–90
  • 14. Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 2004; 364: 2106–12.
  • 15. Pittock SJ, Lennon VA, de Seze J, Vermersch P, Homburger HA, Wingerchuk DM, et al. Neuromyelitis optica and non organ-specific autoimmunity. Arch Neurol 2008; 65: 78- 83.
  • 16. McKeon A, Lennon VA, Jacob A, Matiello M, Lucchinetti CF, Kale N, et al. Coexistence of myasthenia gravis and serological markers of neurological autoimmunity in neuromyelitis optica. Muscle Nerve. 2009; 39: 87- 90.
  • 17. Bergamaschi R, Jarius S, Robotti M, Pichiecchio A, Wildemann B, Meola G. Two cases of benign neuromyelitis optica in patients with celiac disease. J Neurol, 2009; 256: 2097–99.
  • 18. Jacob A, Matiello M, Wingerchuk DM, Lucchinetti CF, Pittock SJ, Weinshenker BG. Neuromyelitis optica: changing concepts. J Neuroimmunol 2007; 187: 126–38.
  • 19. Weinshenker BG, Wingerchuk DM, Vukusic S, Linbo L, Pittock SJ, Lucchinetti CF, et al. Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis. Ann Neurol 2006; 59: 566–9.
  • 20. Pittock SJ, Lennon VA. Aquaporin-4 autoantibodies in a paraneoplastic context. Arch Neurol. 2008; 65: 629–632.
  • 21. Jarius S, Ruprecht K, Wildemann B, Kuempfel T, Ringelstein M, Geis C Kleiter I, et al. Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: A multicentre study of 175 patients. J Neuroinflammation. 2012; 9: 14.
  • 22. Zatjirua V, Butler J, Carr J, Henning F. Neuromyelitis optica and pulmonary tuberculosis: a case-control study Int J Tuberc Lung Dis. 2011; 15:1675- 80.
  • 23. Sahu SK, Giri S, Gupta N. Longitudinal extensive transverse myelitis due to tuberculosis: a report of four cases. J Postgrad Med. 2014; 60: 409-12.
  • 24. Trebst C, Jarius S, Berthele A, Paul F, Schippling S, Wildemann B, et al. Update on the diagnosis and treatment of neuromyelitis optica: recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol 2014; 261:1- 16.
There are 24 citations in total.

Details

Journal Section Makaleler
Authors

Fatma Kurtuluş This is me

Aylin Yaman This is me

Burcu Yüksel

Yasemin Biçer Gömceli This is me

Publication Date March 24, 2018
Submission Date March 16, 2017
Published in Issue Year 2016 Volume: 11 Issue: 3

Cite

AMA Kurtuluş F, Yaman A, Yüksel B, Biçer Gömceli Y. Neuromyelitis Optica and Neuromyelitis Optica Spectrum Disorders : Report of Nine Cases. KSU Medical Journal. March 2018;11(3):17-22.