NMO IgG (Aquaporin-4) autoantibodies in immune-mediated optic neuritis

A Petzold (1) , Sean J Pittock (2) , Vanda Lennon (2) , Cosimo Maggiore (3) , B G Weinshenker (2) , Gordon T Plant (3)

1 Institute of Neurology
2 Mayo Clinic
3 National Hospital for Neurology and Neurosurgery

The clinical course of immune–mediated optic neuritis (ON) will depend upon the specific underlying inflammatory disease. These disorders have traditionally been classified according to clinical and magnetic resonance imaging (MRI) findings. Aquaporin-4 (AQP4) autoantibodies (NMO-IgG) may have diagnostic and prognostic value in patients who present with isolated ON. In this prospective study we evaluated NMO-IgG in 114 patients with optic neuritis in the following contexts: neuromyelitis optica (NMO), multiple sclerosis (MSON), chronic relapsing inflammatory optic neuropathy (CRION), relapsing isolated optic neuritis (RION), and single isolated ON (SION). The proportion seropositive was 56% for NMO (n=9), 0% for MSON (n=28) and 5% for the remaining diagnostic categories (CRION (n=19), RION (n=17) and SION (n=41)). Testing for NMO-IgG in patients with recurrent or severe ON who lack convincing evidence of MS may identify patients who would benefit from immunosuppression rather than MS-directed immunomodulatory therapies.

Mots clés: NEUROIMMUNOLOGY; NEUROOPHTHALMOLOGY; CRION; NMO; aquaporin-4 antibody; optic neuritis

A Petzold, Sean J Pittock, Vanda Lennon, Cosimo Maggiore, B G Weinshenker, et al.. NMO IgG (Aquaporin-4) autoantibodies in immune-mediated optic neuritis. Journal of Neurology, Neurosurgery and Psychiatry, 2009, 81 (1), pp.109. ⟨10.1136/jnnp.2008.146894⟩. ⟨hal-00552709⟩