Clinical and MRI correlates of autoreactive antibodies in multiple sclerosis patients

Garg, Neeta; Zivadinov, Robert; Ramanathan, Murali; Vasiliu, Irene; Locke, Jaclyn; Watts, Kelly; Lema, Jordan; Rajeswary, Jyotsna; Munschauer, Frederick E.; Ambrus, Julian L.; Weinstock‐Guttman, Bianca

doi:10.1016/j.jneuroim.2007.04.008

Cited by 46 publications

(58 citation statements)

References 36 publications

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“…As well, MRI analysis showed significantly higher T2 lesion volume in patients with positive aCl or anti-TPO antibodies after correction for disease duration [18]. On the other hand some studies have shown that there were no significant differences in autoantibodies (ANA, anti-TPO) frequency or titres between MS and control subjects [19].…”

Section: Discussionmentioning

confidence: 97%

Do we need broad immunological work-up in all patients with CIS?

Adamec

Bošković

Škvorc

et al. 2012

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 97%

Do we need broad immunological work-up in all patients with CIS?

Adamec

Bošković

Škvorc

et al. 2012

Journal of the Neurological Sciences

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“…The reported expression frequencies of different ANAs in MS patients have varied widely (from roughly 10 to 60%). For instance, ANAs were expressed by about 30% of MS patients in Northern Greece [22], while studies from America [23] and Australia [24] reported ANA seropositive rates no higher than controls (<10%). Reasons for this wide range of seropositive rates may include race, the antibodies used, measurement methods, and cutoff values.…”

Section: Discussionmentioning

confidence: 99%

Combined Screening for Serum Anti-Nuclear and Anti-Aquaporin-4 Antibodies Improves Diagnostic Accuracy for Distinguishing Neuromyelitis Optica from Multiple Sclerosis

Huang

Yang

et al. 2014

Eur Neurol

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Background/Aims: Neuromyelitis optica spectrum disorders (NMOSDs) and multiple sclerosis (MS) are distinct clinical entities but are poorly distinguished by serum markers, including serum anti-aquaporin-4 (AQP4-Ab). We examined if testing for serum anti-nuclear antibodies (ANAs) and AQP4-Ab improved diagnostic sensitivity for NMOSDs. Methods: Chinese patients with NMOSDs (n = 74) or MS (n = 49) were screened for serum ANAs (all patients) and AQP4-Ab (58/74 NMOSDs and 45/49 MS patients). The NMOSDs group included patients with neuromyelitis optica (NMO; n = 53), recurrent longitudinally extensive transverse myelitis (rLETM; n = 20), and recurrent optic neuritis (n = 1). Results: The seroprevalence rate for ANAs was significantly higher in the NMOSDs group than the MS group (45.9 vs. 2%; p < 0.01). Similarly, AQP4-Ab seroprevalence was higher in NMOSDs than MS (56.9 vs. 4.4%; p < 0.01). Sensitivities and specificities for diagnosing NMOSDs were 51.7 and 97.8% using ANAs, 56.9 and 95.6% using AQP4-Ab, and 74.1 and 93.3% using both assays. Conclusion: Patients with NMO or rLETM had higher ANA seroprevalence than MS patients. Combined detection of both ANAs and AQP4-Ab improves the sensitivity of NMOSDs diagnosis without compromising specificity.

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“…sHPT induces osteitis fibrosa with skeletal deformity and progressive bone loss as well as cardiovascular complications, e.g. extraosseous vessel or tissue calcifications, associated with a high mortality risk [1,2,3,4,5]. Despite advances in medical prophylaxis and treatment, in many patients sHPT is refractory to medical treatment, and surgical parathyroidectomy (PTX) is required [6].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcome after Total Parathyroidectomy for the Management of Secondary Hyperparathyroidism

Stracke

Keller

Steinbach³

et al. 2009

Nephron Clin Pract

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In patients with chronic renal failure, secondary hyperparathyroidism (sHPT) is a common problem requiring surgical parathyroidectomy (PTX) if medical treatment with active vitamin D and calcimimetics fails. To minimize the risk for recurrence, we perform total PTX (tPTX) without autotransplantation. From October 1997 to January 2004, 46 patients (31 men and 15 women) underwent tPTX without autotransplantation (median age 51 years; range 19–80 years; median dialysis time before PTX 5 years; range 0–25 years). Indications for PTX were hyperparathyroid bone disease in 41 cases and calciphylaxis in 5 cases. Postoperatively, all patients were supplemented with vitamin D analogues, both calcitriol and cholecalciferol. Patients were followed up for 4–107 months (median 63 months). Although tPTX was intended in all cases, we saw recurrent or persistent hyperparathyroidism in 26% and supernumerary glands in 15% of cases. In 7 patients (15%), five or more glands were documented and in another four suspected confirming the clinical relevance of intraoperative parathyroid hormone (PTH) measurement. In our study, the positive predictive value of a low intraoperative PTH (<20 pg/ml) for a successful tPTX was 92%. 15 patients received a renal transplant after tPTX without autotransplantation. Here, an uncomplicated hypocalcaemia was noted in 3 patients. Last available calcium levels were between 1.72 and 2.66 mmol/l (median 2.35 mmol/l). After follow-up, active vitamin D was given in a median daily dose of 0.5 μg calcitriol (range 0–2.5 μg/day). There was no evidence of clinical bone disease and no pathological fractures after tPTX after a median observation period of 63 months. tPTX still offers the highest percentage of cure for sHPT, it is safe and postoperatively easily manageable. It allows for adequate supplementation with active vitamin D, and it is the most cost-effective procedure. It should be reconsidered an option for the treatment of sHPT.

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Clinical and MRI correlates of autoreactive antibodies in multiple sclerosis patients

Cited by 46 publications

References 36 publications

Do we need broad immunological work-up in all patients with CIS?

Do we need broad immunological work-up in all patients with CIS?

Combined Screening for Serum Anti-Nuclear and Anti-Aquaporin-4 Antibodies Improves Diagnostic Accuracy for Distinguishing Neuromyelitis Optica from Multiple Sclerosis

Long-Term Outcome after Total Parathyroidectomy for the Management of Secondary Hyperparathyroidism

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