Clinical Analysis And Literature Review In Patients With Disorders Of The Spectrum Of Neuromyelitis Optica With Positive Anti-nuclear Antibody Serum

Aim:To explore the clinical manifestations, laboratory examination, MRI characteristics of neuromyelitis optica spectrum disorders (NMOSDs) with positive anti-nuclear antibody spectrum..Method:The clinical data and sera of19NMOSD patients came from The first affiliated hospital of Zhejiang university between September2010and January2014were collected, which were divided into positive anti-nuclear antibody group (10cases) and anti-nuclear antibody negative groups (9cases). The clinical data, the serological test, imaging examination of patients with two groups of NMOSD were retrospectively analyzed.Results:(1)The NMOSD has strong female predilection,a high ANAs positive rate(52.6%), and always starting with the myelitis;(2)In the ANAs-positive group,the EDSS score of first NMOSD attack was(5.4±3.4), the first year recurrence times was (1.56±1.42)/year, The length of spinal cord lesion was (5.8±2.8). And,in the ANAs-negative group,the EDSS score of first NMOSD attack was(1.7±0.5), the first year recurrence times was (1.17±0.41)/year, The length of spinalcord lesion was (4.8±1.4). The differences in the first attack EDSS score between two groups were statistically significant(P<0.05).(3)The spinal cord lesions were predominantly located in cervical spinal cords in both groups, and brain damage mainly distributed around the ventricles and brain stem. In cerebrospinal fluid, the ANAs-positive group had a high IgG index rate(30%vs12.5%).Conclusion:The NMOSD has strong female predilection, a high ANAs positive rate, and always starting with the myelitis which predominantly located in cervical spinal cords. With severe neurological deficits in the first clinical attack, ANAs-positive NMO patients are more prone to relapse in the first year, long segmental spinal lesions.