A Study Of Clinical Features Of Patients Diagnosed With Neuromyelitis Optica Spectrum Disorders Who Were Both AQP4-Ab Seropositive And Other Autoantibodies Seropositive

Objective to evaluate the clinical features of patients diagnosed with neuromyelitis optica spectrum disorders who were both AQP4-Ab seropositive and Other autoantibodies seropositive,Method all data of patients with nmosd were retrospectively collected in our neurology department from 2015-11 to 2018-2,those patients were divided into four groups as double positive group,single positive group,double negative group and single negative group,patients in the double positive group were both serum AQP4-Ab and Other autoantibodies serum positive.patients in the single positive group were just AQP4-Ab positive.patients in the double negative group were both serum AQP4-Ab and serum Other autoantibodies negative.patients in the single negative group were just AQP4-Ab negative.clinical characteristics were analyzed among the four groups.Result 165 patients participated in the research were 43 patients in the double positive group,55 patients in the single positive group,50 patients in the double negative group and 15 in the single negative group.1.There was a statistically significant difference in the proportion of males and females in the four groups(?~2=15.958,P=0.001).The proportion of females in the double-positive group was the highest(1:20.5).There was a significant difference in the proportion of male and female in double positive group and double negative group and single negative group(P<0.05).2.There was a statistically significant difference in the incidence of optic neuritis between the four groups(?~2=9.274,P=0.026),and the incidence of optic neuritis was highest in the double-positive group(44.2%).The incidence of optic neuritis between the double positive group and the double negative group was statistically significant(?~2=7.533,P=0.007).3.The difference in EDSS scores before treatment between the four groups was statistically significant(f=5.652,P=0.001),and the EDSS score was highest in the double-positive group(5.53±1.79).There was significant difference in the EDSS scores between the double positive group and the double negative group and single negative group(P<0.05).4.There was a statistically significant difference in the number of relapses among the four groups(?~2=12.035,P=0.007).The recurrence rate was highest in the double-positive group(67.4%).There was a significant difference in the number of relapses between the double positive group and the double negative group and single negative group(P<0.05).The cumulative incidence of the four groups was statistically significant(?~2=10.420,P=0.015),and the cumulative incidence of the double-positive group was(2.74±1.87).The cumulative incidence of double positive group and double negative group and single negative group had significant difference(P<0.05).There was a statistically significant difference in the number of incidences during the first year of the four groups(Z=-3.804,P=0.001),and the number of incidences during the first year of the double-positive group was(1.74±0.75).There was a significant difference in the number of incidences during the first year between the double positive group and the double negative group and single negative group(P<0.05).5.The differences of unilateral optic nerve damage in the four groups of VEP were statistically significant(?~2=10.419,P=0.015).The unilateral optic nerve damage was highest in the double-positive group(38.1%).The difference of unilateral optic nerve damage between the double positive group and the other three control groups was statistically significant(P<0.05).There was a statistically significant difference in the prolongation of VEP latency in the four groups(?~2=7.419,P=0.042),and the most prolongation of VEP latency in the double-positive group(66.7%).There was a significant difference in the latency of VEP between the double positive group and the double negative group(?~2=7.152,P=0.012).6.The other autoantibodies positive in the double positive group was ANA(88.37%),SSA(53.48%),and Ro-52(48.83).The differences of the four groups of patients combined with other autoimmune diseases were statistically significant(X2=16.585,P=0.002).The number of patients combined with other autoimmune diseases in double positive group was the highest(32.6%);there was a significant difference between the two positive groups and the three control groups(P<0.05).7.There were significant differences in CSF-Ig G between the four groups(Z=-2.549,P=0.011)and CSF-lg G in the double-positive group(70.67±73.25 mg/L).There was significant difference in CSF-Ig G between the double positive group and the double negative group(Z=-3.624,P=0.001).8.The difference in the length of spinal cord injury between the four groups was statistically significant(Z=-2.853,P=0.04),and the length of spinal cord injury was the longest in the double-positive group(7.30±4.84 vertebrae).There was significant difference in the length of spinal cord injury between double positive group and double negative group and single negative group(P<0.05).There were significant differences in the long T1 and long T2 signals between the four groups of MRI lesions(X2=26.966,P=0.001).The MRI lesions of double-positive group showed long T1 and long T2 signals(73.3%),and there was significant difference between double positive group and double negative group and single negative group(P<0.05).The difference was statistically significant in Four groups of spinal cord MRI lesions showed in long strips(X2=12.196,P=0.010).Conclusion Serum AQP4 antibody positive patients with serum Other autoantibodies positive NMOSD patients with high proportion,high incidence of optic neuritis,severe disability,easy to relapse,VEP unilateral optic nerve damage,VEP latency-based,spinal cord injury length Long,spinal cord lesions showed in long strips of long T1 long T2 signals,increased CSF-Ig G,Other autoantibodies mainly ANA,SSA,Ro-52 antibody.Often combined with other autoimmune diseases.