The Clinical Characteristics Of Neuromyelitis Optica Spectrum Disease With Autoimmune Diseases

Background and Objective:Neuromyelitis optica spectrum disorder(NMOSD)is an autoimmune syndrome characterized by optic nerve and spinal cord inflammation.NMOSD often associated with other autoimmune diseases,including systemic lupus erythematosus(SLE),Sjogren Syndrome(SS),autoimmune thyroid disease(AITD),and other autoimmune diseases.At present,there is few studies have examined the relationship between NMOSDs with and without autoimmune diseases.Therefore,to investigate and compare the clinical features,MRI,laboratory test between neuromyelitis optica spectrum disorders(NMOSD)with and without autoimmune diseases can improve the understanding of NMOSD combined with other autoimmune diseases,and help to diagnose NMOSD.Methods:A total of 261 NMOSD patients diagnosed at admission in the Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University,from January 2015 to July 2018,were divided into 2 groups: positive group(n=20,with autoimmune diseases),and negative group(n=241,without autoimmune diseases).The positive group included 12 cases of Sjogren's syndrome(SS),3 cases of systemic lupus erythematosus(SLE),1 case of undifferentiated connective tissue disease(UCTD),and 4 cases of autoimmune thyroid disease.The clinical,laboratory and imaging features between the two groups were assessed.Results:1 Compare with NMOSD without autoimmune disease(negative group),NMOSD with autoimmune(positive group)was more common in females(P=0.039),more higher in EDSS score(p=0.021),more recurring,the difference is statistically significant(p<0.05).2 No differences were observed in MRI characteristics between the two groups.(p>0.05)3 In terms of laboratory indicators,ANA,anti-SSA antibodies(SSA),anti-Ro-52 antibodies(Ro-52),were significantly higher positive group(p?<?0.05).CSF white blood cell(WBC)and protein were significantly lower in positive group,while CSF glucose was significantly higher in positive group(p=0).Conclusions:1 Compare with NMOSD without autoimmune disease,NMOSD with autoimmune was more common in females2 The clinical features and CSF of NMOSD with autoimmune disease are not much different from NMOSD without autoimmune disease,and their effects are limited.3 The NMOSD combined with other autoimmune diseases has a higher positive rate of autoimmune antibodies,a relatively poor prognosis,and a higher recurrence rate.4 Improve the test of autoimmune antibodies in Neuromyelitis Optica Spectrum Disorders can help improve the understanding of NMOSD and prevent missed diagnosis of other autoimmune diseases...