Seropositivity of Aquaporin-4-IgG on neuromyelitis optica spectrum disorders (NMOSD) in Indonesia

State-of-the-Art Review: Demyelinating Diseases in Indonesia

“…In Indonesia, we found only two studies on NMOSD, one of which reported 19 NMOSD cases in Indonesia [ 24 , 25 ]. It has to be noted that these studies may not represent the actual burden of disease, and combined with the scarcity of AQP4-IgG testing facilities, it is likely that we underestimate the prevalence of NMOSD in Indonesia.…”

“…The reported NMOSD patients in Indonesia were predominantly female with a mean age of 35.5 ± 11.4 years old, similar with global reports that document female predominance in NMOSD. The majority of Indonesian NMOSD patients (12 out of 15) had positive AQP4-IgG, with higher relapse rate compared to seronegative patients [ 24 ]. This is similar to other studies that showed NMOSD with negative AQP4-IgG are more frequently monophasic [ 19 ].…”

“…Optic nerve lesions were demonstrated in both seropositive and seronegative groups of Indonesian NMOSD patients, while longitudinally extensive transverse myelitis (LETM) was found predominantly in AQP4-IgG-seropositive patients. Multiple T2 high signal brain lesions were only found in AQP4-IgG-seropositive patients [ 24 ]. In our center, MRI examinations of the brain and spinal cord for suspected NMO cases are performed with the same standard imaging protocol as described in Table 1 .…”