Clinical features of patients with multiple sclerosis from a survey in 				Shanghai, China

Cheng, Qi; Miao, Lei; Zhang, Jian; Guan, Yangtai; Liu, Z.G.; Wang, X.J.; Sun, Xiaojiang; Zhi-gang, Zhao; Song, Yanyan; Ding, Xiaoyi; Guo, Zheng-Liang; Cheng, Xiaojuan; Chen, S.D.; Jiang, Guo-Xin; Fredrikson, Sten

doi:10.1177/1352458507087844

Cited by 27 publications

(23 citation statements)

References 17 publications

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“…The diagnostic criteria for NMO proposed by Wingerchuk et al [2] facilitate its distinction from MS. However, MS patients with lesions involving the spinal cord and optic nerves are very common in Asian countries, including China [3] , resulting in the difficulty in discriminating it from NMO. Beyond this, early diagnosis is critical for these two diseases, because of their distinct treatment regimens, especially during the first episode, when they are termed 'clinically isolated syndromes' [4] .…”

Section: Introductionmentioning

confidence: 99%

Aquaporin 4 Antibodies in the Cerebrospinal Fluid Are Helpful in Diagnosing Chinese Patients with Neuromyelitis Optica

Long

Qiu

Liu

et al. 2012

Neuroimmunomodulation

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Objective: It was the aim of this study to compare the diagnostic efficiency of anti-aquaporin 4 (AQP4) antibody detection between serum and cerebrospinal fluid (CSF) samples in Chinese patients with central nervous system demyelinating diseases. Methods: Anti-AQP4 antibodies were detected by a cell-based assay. We calculated the sensitivity, specificity and coherence in 118 patients with neuromyelitis optica (NMO, n = 39), multiple sclerosis (n = 34), longitudinally extensive transverse myelitis (LETM, n = 22), optic neuritis (ON, n = 6), opticospinal multiple sclerosis (n = 8) and acute partial transverse myelitis (n = 9). Results: Forty-four serum samples (33.8%) were positive for anti-AQP4 antibodies. Anti-AQP4 antibody seropositivity was 76.9, 59.1 and 16.7% in patients with NMO, LETM and ON, respectively. Sixty-five CSF samples (50%) were positive for anti-AQP4 antibodies. Anti-AQP4 antibody positivity was 87.1, 81.8, 83.3, 62.5 and 11.8% in patients with NMO, LETM, ON, opticospinal multiple sclerosis and multiple sclerosis, respectively. The ĸ value of the coherence test was 0.585 (p < 0.0001) between the two types of samples. The antibody positivity rate was significantly different between the two body fluids (p = 0.0008, McNemar test). The sensitivity and specificity were 74.3 and 100% in serum, 85.7 and 88.2% in CSF, and 94.3 and 88.2% for serum and CSF combined, respectively. Conclusion: The sensitivity of anti-AQP4 antibodies in the CSF was higher than that in the serum, and their combined use is helpful in diagnosing Chinese patients with NMO.

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Section: Introductionmentioning

confidence: 99%

Aquaporin 4 Antibodies in the Cerebrospinal Fluid Are Helpful in Diagnosing Chinese Patients with Neuromyelitis Optica

Long

Qiu

Liu

et al. 2012

Neuroimmunomodulation

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“…This has been confirmed in many studies, and the presence of such antibodies is now among the diagnostic criteria for NMO 5,6 .…”

Section: Discussionmentioning

confidence: 59%

“…A specific IgG autoantibody, NMO-IgG, selectively targeting aquaporin 4 (AQP4), which accumulates in the central nervous system (CNS) microvessels, pia, subpia, and Virchow-Robin space, has been confirmed by indirect immunofluorescence with a composite substrate of mouse tissue 3,4 . According to this antibody, the new diagnostic criteria for NMO proposed by Wingerchuk et al facilitate its distinction from multiple sclerosis (MS) 5,6 . In subsequent studies, analysis of pathological brain lesions in NMO patients revealed a pattern of vasculocentric immune complex deposition and AQP4 loss ORIGINAL ARTICLE identical to that seen in NMO lesions, suggesting that AQP4 antibodies are related to NMO pathology 7,8 .…”

mentioning

confidence: 99%

Serum-Positive and -Negative AQP4 Antibody NMO in Chinese Patients

Long

Liu

2012

Can. J. Neurol. Sci.

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232Neuromyelitis optica (NMO) is a severe idiopathic immunomediated inflammatory demyelinating and necrotizing disease that is characterized by transverse myelopathy and optic neuropathy. The exact etiology and mechanisms of NMO remain unknown. Serological and clinical evidence of B cell autoimmunity has been observed in a high proportion of patients, 1 suggesting a prominent role for humoral mechanisms in the pathogenesis of NMO. Neuromyelitis optica lesions show a marked deposition of immunoglobulins and complement in a characteristic perivascular rosette pattern along the outer rim of thickened vessel walls 2 . A specific IgG autoantibody, NMO-IgG, selectively targeting aquaporin 4 (AQP4), which accumulates in the central nervous system (CNS) microvessels, pia, subpia, and Virchow-Robin space, has been confirmed by indirect immunofluorescence with a composite substrate of mouse tissue 3,4 . According to this antibody, the new diagnostic criteria for NMO proposed by Wingerchuk et al facilitate its distinction from multiple sclerosis (MS) 5,6 . In subsequent studies, analysis of pathological brain lesions in NMO patients revealed a pattern of vasculocentric immune complex deposition and AQP4 loss ABSTRACT: Objective: To compare the clinical features of our sero-negative and sero-positive neuromyelitis optica (NMO) patients. Methods: Thirty-nine patients with NMO were recruited and analyzed retrospectively. Serum aquaporin 4 (AQP4) antibody status was determined by a cell-based assay. For the sero-negative patients, cerebrospinal fluid (CSF) and serum samples were re-tested using the cell-based assay and an indirect immunofluorescence assay. Results: By the cell-based assay, 30 patients (76.92%, 30/39), were positive for AQP4 antibodies in serum and 37 patients (94.9%, 37/39), had a CSF-positive antibody status. Seven NMO patients (17.9%, 7/39) were sero-negative by the cell-based assay but demonstrated positive CSF results. By indirect immunofluorescence, the remaining two patients, who had no AQP4 antibodies in serum or CSF by the cell-based assay, were positive for IgG antibodies in serum, which selectively targeted the central nervous system microvessels, pia, subpia, Virchow-Robin space, kidney, and stomach. There were no significant differences between the sero-positive and sero-negative NMO groups among their demographic and clinical data. Conclusions: Repeating the test using a different assay or CSF is helpful to clarify whether sero-negative NMO patients do in fact carry AQP4 antibodies. ORIGINAL ARTICLEidentical to that seen in NMO lesions, suggesting that AQP4 antibodies are related to NMO pathology 7,8 .Although more than 15 different immunoassays for the detection of AQP4 antibodies in patients with NMO have been developed, only a proportion of patients (33-91% among Western NMO cases and 41.7-91% among Japanese opticospinal MS (OSMS) are positive for AQP4 antibodies in serum 3,9,10 . In other words, the number of sero-negative NMO patients is not negligible.https://www.cambridge.org/core/terms. h...

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“…Based on limited epidemiologic studies, the prevalence of MS in mainland China is estimated at 1.39/100,000 persons, much lower than in adjacent regions such as Hong Kong, Taiwan, Japan, and South Korea (5-10/100,000). [17][18][19] Although there is no apparent reason for a lower MS presence in mainland China compared with adjacent regions, the actual number of such patients is not fewer given China's large population base. For management of acute relapses, steroids, plasma exchange, and IV immunoglobulin are available.…”

Section: Challenges Facing Practicing Neurolo-gists In Chinamentioning

confidence: 99%

Neurology and neurologic practice in China

Shi¹,

Jia²

2011

Neurology

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In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions. Neurology

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Clinical features of patients with multiple sclerosis from a survey in Shanghai, China

Abstract: Clinical features of patients with MS are described based on the information from the largest case series reported among Chinese. Comparisons and discussions are made with findings from the other populations.

Cited by 27 publications

References 17 publications

Aquaporin 4 Antibodies in the Cerebrospinal Fluid Are Helpful in Diagnosing Chinese Patients with Neuromyelitis Optica

Aquaporin 4 Antibodies in the Cerebrospinal Fluid Are Helpful in Diagnosing Chinese Patients with Neuromyelitis Optica

Serum-Positive and -Negative AQP4 Antibody NMO in Chinese Patients

Neurology and neurologic practice in China

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