Clinical Analysis Of Neuromyelitis Optica Spectrum Disorders

ObjectTo analysis the clinical manifestation,radiological data,laboratory findings of neuromyelitis optica spectrum disorders(NMOSD)and doctors can have a deeper understanding of the diseases.MethodsThe clinical manifestations,radiological data,laboratory findings of 70 patients were analyzed,which came from People’s Hospital of Zhengzhou University neurology department from december 2015 to december 2017.ResultAmong them,70 patients were included in the NMOSD diagnostic criteria,including 9 males(12.86%)and 61 females(87.14%).The age of first visit was between 15 and 80 years,with an average age of 43.76±15.93.There were 14 cases(20%)had inducement before onset,which were fatigue 4 cases,cold 7 cases,and emotional stress 3 cases.A total of 15 patients with autoimmune diseases(21.43%),which respectively sjogren’s syndrome 6 cases,hyperthyroidism 3 cases,hashimoto’s thyroiditis 1 case,systemic lupus erythematosus 1 case,rheumatoid arthritis 1 case and autoimmune hepatitis 1 case.The first episode was visual impairment 25 cases,hiccup、nausea and vomiting 8 cases,physical weakness 14 cases,and abnormal sensation 23 cases(including pain 3 cases,numbness 20 cases).Major clinical manifestations include the following aspects: vision loss 41 cases,hiccup,nausea and vomiting 11 cases,body weakness 45 cases,paraesthesia 50 cases(including pain 14 cases,numbness 33 cases and itching 3 cases),mental symptoms 1 case,urination dysfunction 9 cases,convulsions 9 cases,memory decline 2 cases,sleepiness 2 cases,and difficulty in opening eyes were 2 cases.Neuroimaging have intracranial parenchymal,mainly involving the part of hemicerebrum 17 cases,optic nerve 25 cases,spinal cord(mainly for the neck section of the spinal cord 25 cases and thoracic segmental spinal cord 32 cases),diencephalon 10 cases,brainstem 10 cases,medulla 15 cases.There are a total of 32 cases(45.71%)in this study with immune index was abnormal,respectively abnormal project of thyroglobulin antibody 13 cases,thyroid peroxidase antibody 10 cases,antinuclear antibodies 10 cases,anti SSA 13 cases,SSB antibody 4 cases,Ro-52 antibody 17 cases,resistance to protease 3 antibodies 1 case,rheumatoid factor 1 case,fight U1-nRNP 1 case,resisting the centromere antibodies 1 case and resistance to histones 1 case.Two cases(2.86%)of tumor markers were raised,including increased CA-199 1 case and CA-125 1 case.In this study,67 patients with positive AQP-4 antibody and 3 patients with negative AQP-4 antibody were negative.Results of cerebrospinal fluid examination: 12 patients with elevated pressure,54 normal subjects and 4 patients with lower pressure.There were 25 cases of normal cerebrospinal fluid cells,and 45 cases were increased.There were 6 cases of cerebrospinal fluid sugar reduction,53 normal patients and 6 reduction.There were 8 cases of cerebrospinal fluid chloride reduction and 62 normal patients.There were 26 patients with normal cerebrospinal fluid protein,and 44 cases were elevated.The treatment was mainly treated with glucocorticoid,and a small amount of immunoglobulin was used for treatment.There were 63 cases of sensitive patients,7 of whom were not sensitive.There were 19 cases of immunosuppressive agents in the treatment of retreats,and the types of immunosuppressive agents were those of mycophenol,azathioprine and cyclophosphamide.The follow-up period was 6-20 months and 4 cases were lost.Follow-up of all patients with recurrence of 24 cases,25 patients had different degrees of legacy sequelae(mainly for visual impairment,limb motor function and sensory dysfunction,different aspects such as the bladder dysfunction).Conclusion:1.The neuromyelitis optica spectrum disorders(NMOSD)were tend to take place in young and middle-aged female.When someone who catch cold or tired after the sudden vision loss,and intractable hiccups,nausea and vomiting,body paresthesia and movement function disorder should consider the possibility of NMOSD.2.There is a characteristic significance in the disease of optic nerve,cervical and thoracic spinal cord.In addition,bilateral cerebral hemisphere,ventricle system,brain stem also often suffer.For patients suspected of diagnosing the spectrum of optic neuritis.3.There was no statistical difference between the age of onset,gender,initial symptoms,major clinical manifestations,impact studies,and laboratory examination in the normal group of immunologic function and immunocompromised group.