The Study On Clinical Characteristics Of Neuromyelitis Optica Spectrum Disorders With Positive Autoantibodies

Objective: To analyze the clinical characteristics of patients with neuromyelitis optica spectrum disorders(NMOSDs)with or without autoantibodies.To further explore the relationship between autoantibodies and the clinical characteristics of NMOSD in the acute phase.Methods: The data of 40 patients with NMOSD were collected in the Chenzhou No.1 People’s Hospital from August 2018 to December 2020.All patients had acute onset and received acute treatment in our hospital.All the patients were divided into two groups according to the status of autoantibody.The demographic information,clinical symptoms,autoimmune disease,blood biochemical examination,cerebrospinal fluid(CSF)examination,imaging examination and extended disability rating scale(EDSS)scores before and after treatment were recorded and assessed.Results:1.Among the 40 patients,60.0%(24/40)were associated with positive autoantibodies(positive group),and ANA had the highest detection rate of autoantibodies(42.5%),followed by anti-SSA antibody,anti-Ro-52 antibody and anti-SSB antibody.27.5%(11/40)patients were associated with one or more systemic autoimmune diseases.The most concomitant disease was Sj?gren’s syndrome,and it was more common in the autoantibody positive group(41.7% vs 6.3%,P = 0.027).Patients in the positive group were more significantly associated with aquaporin 4immunoglobulin G(AQP4-Ig G)(79.2% vs 43.8%,P = 0.041).2.The main clinical symptoms of the two groups were limb weakness,paresthesia,vision loss and pain(P > 0.05).Up to 57.5% patients feld pain.3.In the positive group,there were higher ESR(P = 0.017),lowwe UA(P = 0.044),lower albumin(P = 0.048),and there was no difference in CRP,homocysteine and thyroid function.4.There were not statistically significant in CSF pressure,CSF nucleated cell count,protein quantification,Ig G and glucose between two groups(P > 0.05).5.In the positive group,the longest affected segment[5.00(3.75,8.25)]was longer than that in the negative group [3.50(2.00,5.00)](P = 0.013),and the location and incidence of brain and spinal cord lesions were similar in both groups(P > 0.05).6.There was no difference between the two groups in acute stage.Before and after treatment,the EDSS score of the positive group was higher than negative group(P = 0.047,P = 0.006),and the EDSS score in negative group decreased more rapidly than positive group(P = 0.039).Conclusion:NMOSD patients with positive autoantibodies were more likely to be associated with AQP4-Ig G positive and other autoimmune diseases.Compared with autoantibody-negative patients,autoantibody-positive patients had higher ESR,lower UA and albumin,longer spinal cord involvement,and worse prognosis.