Journal article
Prevalence of anti-aquaporin 4 antibody in a diagnostic cohort of patients being investigated for possible neuromyelitis optica spectrum disorder in Western Australia
Journal of Neuroimmunology, Vol.324, pp.76-80
2018
Abstract
Objective
To evaluate the prevalence of anti-AQP4 antibody in serum and CSF samples from patients being investigated for possible neuromyelitis optica spectrum disorder (NMOSD) referred to the PathWest State reference laboratory using a sensitive cell-based assay (CBA).
Background
NMOSD is an inflammatory CNS disease distinct from MS, which is relatively rare in Western countries. A proportion of patients with NMOSD have detectable serum IgG antibodies that target the water channel aquaporin-4 (AQP4-IgG), but the frequency varies in different populations studied and according to the assay method employed.
Methods
Sera or CSF from a diagnostic cohort of 196 consecutive patients with possible NMOSD which had previously been screened by indirect immunofluorescence (IIF) on primate cerebellum were re-tested for AQP4-IgG reactivity to the M1 and M23 isoforms of AQP4using a commercial CBA. A control group of 205 patients with definite MS was also included in the study.
Results
Of the 196 patients, only 5 sera were AQP4-IgG positive, representing 2.6% of patients in the diagnostic cohort. All 5 AQP4-IgG positive patients fulfilled the 2015 revised diagnostic criteria for NMOSD and were females of varied ethnic origins, 4 of whom had longitudinally extensive transverse myelitis. The CBA confirmed AQP4-IgG positivity in the four patients previously reported as positive by IIF, and an additional patient with NMOSD who had previously been diagnosed as MS was also identified. None of the 205 MS sera were AQP4-IgG positive.
Conclusions
Our study confirms the utility and greater reliability of the M1/M23 CBA for detecting AQP4-IgG in patients with possible NMOSD, and indicates a prevalence of seropositive NMOSD in the Western Australian population similar to that in other Western populations.
Details
- Title
- Prevalence of anti-aquaporin 4 antibody in a diagnostic cohort of patients being investigated for possible neuromyelitis optica spectrum disorder in Western Australia
- Authors/Creators
- M.J. Fabis-Pedrini (Author/Creator) - Perron Institute for Neurological and Translational ScienceC. Bundell (Author/Creator) - Pathwest Laboratory MedicineC-K Wee (Author/Creator) - Perron Institute for Neurological and Translational ScienceM. Lucas (Author/Creator) - Sir Charles Gairdner HospitalA. McLean-Tooke (Author/Creator) - Queen Elizabeth II Medical CentreF.L. Mastaglia (Author/Creator) - Perron Institute for Neurological and Translational ScienceW.M. Carroll (Author/Creator) - The University of Western AustraliaA.G. Kermode (Author/Creator) - Perron Institute for Neurological and Translational Science
- Publication Details
- Journal of Neuroimmunology, Vol.324, pp.76-80
- Publisher
- Elsevier
- Identifiers
- 991005542072307891
- Copyright
- © 2018 Elsevier B.V.
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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