Analysis Of The Clinical Characteristics Of Neuromyelitis Optica Spectrum Diseases Combined With Other Positive Autoimmune Antibodies

Objective: Optic myelitis spectrum disease(neuromyelitis optica spectrum disease,NMOSD)as an autoimmune disease,May be combined with other autoimmune antibody positive,Such as anti-nuclear antibodies(Anti-nuclear antibody,ANA),anti-Sjogren’s syndrome type A antibody(Sjogren syndrome A antibody,SSA),anti-thyroglobulin antibody(Anti-thyroglobulin antibodies,TGAb)class.The previous domestic and foreign studies are mostly case reports and small sample studies.This study aimed to analyze the clinical characteristics of Chinese NMOSD patients with positive other autoimmune antibodies and explore the relationship.Methods:Collect 100 patients who met the diagnostic criteria for NMOSD established by the 2015 International NMO Group and were hospitalized in the Neurology Department of the First Affiliated Hospital of China Medical University from March 2021 to October2022,of which 69 patients met the inclusion and exclusion criteria.Basic information and clinical data(gender,initial age,initial symptoms and main clinical manifestations,extended disability status scale at enrollment,recurrence times),physical examination data(imaging examination such as magnetic resonance,evoked potential electrophysiological examination),and laboratory results(serum or cerebrospinal fluid demyelinating antibodies,other autoimmune antibodies,including anti-ANA antibodies,anti-Sm antibodies,anti-SSA antibodies,anti-SSB antibodies,anti-neutrophil cytoplasmic antibodies,anti-cardiolipin antibodies,anti-Ro-52 antibodies,thyroid antibodies,etc.)were collected.According to whether with other autoimmune antibody positive,divided into combining other autoimmune antibody positive group and not combined other autoimmune antibody positive group,analysis of two groups of patients in the first age,first symptoms,main clinical manifestations,the severity of the disease,recurrence and imaging,evoked potential physiological examination,cerebrospinal fluid biochemical results have statistical significance.Results:1.NMOSD patients with late and very late onset onset aged 50 years were more likely to be positive with other autoimmune antibodies(p=0.034).2.NMOSD patients with positive anti-AQP 4 antibodies were more likely to have positive other autoimmune antibodies(p=0.031).3.NMOSD patients with other autoimmune-positive antibodies relapsed more frequently(p=0.026).4.Early-onset NMOSD patients with other autoimmune antibodies were more likely to have paresthesia than early-onset NMOSD patients without positive other autoimmune antibodies(p=0.029).5.Among NMOSD patients positive against AQP 4,patients without other positive autoimmune antibodies were more likely to have visual symptoms as first symptoms(p=0.033).6.Among NMOSD patients with positive anti-AQP 4 antibodies,patients with other positive autoimmune antibodies were more likely to develop paresthesia(p=0.033).7.In NMOSD with negative anti-AQP 4 antibodies,patients positive with other autoimmune antibodies were more lesions than those with other positive ones(p=0.015).Conclusion: This study found that patients with late-onset and very late-onset NMOSD were more likely to have positive autoimmune antibodies,and NMOSD patients with positive autoimmune antibodies had higher anti-AQP 4 antibody positive rate,maybe more severe severity and more recurrence,which should be paid attention to in clinical practice.