Neuromyelitis optica and aquaporin‐4 (AQP4) autoantibodies in consecutive optic neuritis patients in Southern Finland

. Purpose:  To analyse the frequency of neuromyelitis optica (NMO) among consecutive optic neuritis (ON) patients in Southern Finland and the feasibility of Aquaporin‐4 (AQP4) autoantibody assay in the diagnosis of NMO. Methods:  Consecutive patients with symptoms suggestive of acute ON and managed...

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Veröffentlicht in:Acta ophthalmologica (Oxford, England) England), 2014-06, Vol.92 (4), p.387-391
Hauptverfasser: Siuko, Mika, Tienari, Pentti J., Saastamoinen, Kari‐Pekka, Atula, Sari, Miettinen, Aaro, Kivelä, Tero, Setälä, Kirsi
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container_title Acta ophthalmologica (Oxford, England)
container_volume 92
creator Siuko, Mika
Tienari, Pentti J.
Saastamoinen, Kari‐Pekka
Atula, Sari
Miettinen, Aaro
Kivelä, Tero
Setälä, Kirsi
description . Purpose:  To analyse the frequency of neuromyelitis optica (NMO) among consecutive optic neuritis (ON) patients in Southern Finland and the feasibility of Aquaporin‐4 (AQP4) autoantibody assay in the diagnosis of NMO. Methods:  Consecutive patients with symptoms suggestive of acute ON and managed in the Helsinki University Central Hospital were evaluated critically screened for AQP4 autoantibody during a 47.5‐month period. The antibodies were determined using radioimmunoprecipitation method. AQP4 index >15 was considered positive, 10–15 borderline and
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Purpose:  To analyse the frequency of neuromyelitis optica (NMO) among consecutive optic neuritis (ON) patients in Southern Finland and the feasibility of Aquaporin‐4 (AQP4) autoantibody assay in the diagnosis of NMO. Methods:  Consecutive patients with symptoms suggestive of acute ON and managed in the Helsinki University Central Hospital were evaluated critically screened for AQP4 autoantibody during a 47.5‐month period. The antibodies were determined using radioimmunoprecipitation method. AQP4 index &gt;15 was considered positive, 10–15 borderline and &lt;10 normal. Brain magnetic resonance imaging (MRI) was performed for all patients. Results:  Of the 300 patients with suspected ON, 191 were eventually diagnosed as ON, and 66 (35%) of them had a previous diagnosis or were diagnosed with multiple sclerosis (MS). Of the 125 patients without MS diagnosis, 62 (50%) had demyelinative lesions in MRI, which is a risk factor for developing MS. Two patients (1.1%; 95% CI 0.3–4.5) fulfilled the criteria of NMO. Positive AQP4 antibodies were found in three patients (1.6% 95% CI 0.3–4.5), one of them had NMO, one had MS and one became diagnosed with MS a month later. Borderline autoantibody levels were found in 10 patients, 7 of whom had MS. Conclusions:  NMO is rare among ON patients in the population of Southern Finland. In this small cohort, the sensitivity and positive predictive values of the AQP4 autoantibody index for NMO were low, 1/2 and 1/3 respectively, and do not support initiating routine screening.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.12187</identifier><identifier>PMID: 23773223</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aquaporin 4 - immunology ; Aquaporins ; aquaporin‐4 autoantibody ; Autoantibodies - blood ; Autoantigens - immunology ; autoimmune optic neuropathy ; Enzyme-Linked Immunosorbent Assay ; Female ; Finland - epidemiology ; Humans ; Magnetic Resonance Imaging ; Male ; Medical research ; Middle Aged ; Multiple sclerosis ; neuromyelitis optica ; Neuromyelitis Optica - diagnosis ; Neuromyelitis Optica - epidemiology ; Neuromyelitis Optica - immunology ; NMR ; Nuclear magnetic resonance ; Ophthalmology ; optic neuritis ; Optic Neuritis - diagnosis ; Optic Neuritis - epidemiology ; Optic Neuritis - immunology ; Radioimmunoprecipitation Assay ; Young Adult</subject><ispartof>Acta ophthalmologica (Oxford, England), 2014-06, Vol.92 (4), p.387-391</ispartof><rights>2013 Acta Ophthalmologica Scandinavica Foundation. 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Purpose:  To analyse the frequency of neuromyelitis optica (NMO) among consecutive optic neuritis (ON) patients in Southern Finland and the feasibility of Aquaporin‐4 (AQP4) autoantibody assay in the diagnosis of NMO. Methods:  Consecutive patients with symptoms suggestive of acute ON and managed in the Helsinki University Central Hospital were evaluated critically screened for AQP4 autoantibody during a 47.5‐month period. The antibodies were determined using radioimmunoprecipitation method. AQP4 index &gt;15 was considered positive, 10–15 borderline and &lt;10 normal. Brain magnetic resonance imaging (MRI) was performed for all patients. Results:  Of the 300 patients with suspected ON, 191 were eventually diagnosed as ON, and 66 (35%) of them had a previous diagnosis or were diagnosed with multiple sclerosis (MS). Of the 125 patients without MS diagnosis, 62 (50%) had demyelinative lesions in MRI, which is a risk factor for developing MS. Two patients (1.1%; 95% CI 0.3–4.5) fulfilled the criteria of NMO. Positive AQP4 antibodies were found in three patients (1.6% 95% CI 0.3–4.5), one of them had NMO, one had MS and one became diagnosed with MS a month later. Borderline autoantibody levels were found in 10 patients, 7 of whom had MS. Conclusions:  NMO is rare among ON patients in the population of Southern Finland. In this small cohort, the sensitivity and positive predictive values of the AQP4 autoantibody index for NMO were low, 1/2 and 1/3 respectively, and do not support initiating routine screening.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aquaporin 4 - immunology</subject><subject>Aquaporins</subject><subject>aquaporin‐4 autoantibody</subject><subject>Autoantibodies - blood</subject><subject>Autoantigens - immunology</subject><subject>autoimmune optic neuropathy</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Multiple sclerosis</subject><subject>neuromyelitis optica</subject><subject>Neuromyelitis Optica - diagnosis</subject><subject>Neuromyelitis Optica - epidemiology</subject><subject>Neuromyelitis Optica - immunology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Ophthalmology</subject><subject>optic neuritis</subject><subject>Optic Neuritis - diagnosis</subject><subject>Optic Neuritis - epidemiology</subject><subject>Optic Neuritis - immunology</subject><subject>Radioimmunoprecipitation Assay</subject><subject>Young Adult</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0c1qFTEUwPEgiv3QhS8gATft4rb5mOTMLC_FVqFYpQruhszMGUyZm0zzYbk7H8Fn9ElM79QuBDGbZPHLn4RDyCvOTnhZp8bHEy54DU_IPgelVhJ0_fTxrL7ukYMYbxjTXOvqOdkTEkAKIffJ3QfMwW-2ONlkI_Vzsr2hxg3U3GYz-2Ddrx8_K3q0_vSxOqYmJ29csp0fLEZqHe29i9jnZL_jcpu6UtzFZpMsurRj1z6nbxgcPbduKvkX5NlopogvH_ZD8uX87eezd6vLq4v3Z-vLVV8JDivExjQcBJN87CqBneDMQK2aQY-SiWFEqIdKMDQglKkV6JFDp3pd93KoDJOH5GjpzsHfZoyp3djY41TegD7HlmshVNMAqP9TJTRIzbgo9M1f9Mbn4MpH7pWqNUDDizpeVB98jAHHdg52Y8K25ay9H1xbBtfuBlfs64di7jY4PMo_kyrgdAF3dsLtv0vt-up6Sf4GXbii9A</recordid><startdate>201406</startdate><enddate>201406</enddate><creator>Siuko, Mika</creator><creator>Tienari, Pentti J.</creator><creator>Saastamoinen, Kari‐Pekka</creator><creator>Atula, Sari</creator><creator>Miettinen, Aaro</creator><creator>Kivelä, Tero</creator><creator>Setälä, Kirsi</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>201406</creationdate><title>Neuromyelitis optica and aquaporin‐4 (AQP4) autoantibodies in consecutive optic neuritis patients in Southern Finland</title><author>Siuko, Mika ; Tienari, Pentti J. ; Saastamoinen, Kari‐Pekka ; Atula, Sari ; Miettinen, Aaro ; Kivelä, Tero ; Setälä, Kirsi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4217-ee9a9172031fb42eb210a7859d6f302dfe78d420ea725a8576f17b5c68c3d4a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aquaporin 4 - immunology</topic><topic>Aquaporins</topic><topic>aquaporin‐4 autoantibody</topic><topic>Autoantibodies - blood</topic><topic>Autoantigens - immunology</topic><topic>autoimmune optic neuropathy</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Female</topic><topic>Finland - epidemiology</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Multiple sclerosis</topic><topic>neuromyelitis optica</topic><topic>Neuromyelitis Optica - diagnosis</topic><topic>Neuromyelitis Optica - epidemiology</topic><topic>Neuromyelitis Optica - immunology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Ophthalmology</topic><topic>optic neuritis</topic><topic>Optic Neuritis - diagnosis</topic><topic>Optic Neuritis - epidemiology</topic><topic>Optic Neuritis - immunology</topic><topic>Radioimmunoprecipitation Assay</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Siuko, Mika</creatorcontrib><creatorcontrib>Tienari, Pentti J.</creatorcontrib><creatorcontrib>Saastamoinen, Kari‐Pekka</creatorcontrib><creatorcontrib>Atula, Sari</creatorcontrib><creatorcontrib>Miettinen, Aaro</creatorcontrib><creatorcontrib>Kivelä, Tero</creatorcontrib><creatorcontrib>Setälä, Kirsi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siuko, Mika</au><au>Tienari, Pentti J.</au><au>Saastamoinen, Kari‐Pekka</au><au>Atula, Sari</au><au>Miettinen, Aaro</au><au>Kivelä, Tero</au><au>Setälä, Kirsi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neuromyelitis optica and aquaporin‐4 (AQP4) autoantibodies in consecutive optic neuritis patients in Southern Finland</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><addtitle>Acta Ophthalmol</addtitle><date>2014-06</date><risdate>2014</risdate><volume>92</volume><issue>4</issue><spage>387</spage><epage>391</epage><pages>387-391</pages><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>. Purpose:  To analyse the frequency of neuromyelitis optica (NMO) among consecutive optic neuritis (ON) patients in Southern Finland and the feasibility of Aquaporin‐4 (AQP4) autoantibody assay in the diagnosis of NMO. Methods:  Consecutive patients with symptoms suggestive of acute ON and managed in the Helsinki University Central Hospital were evaluated critically screened for AQP4 autoantibody during a 47.5‐month period. The antibodies were determined using radioimmunoprecipitation method. AQP4 index &gt;15 was considered positive, 10–15 borderline and &lt;10 normal. Brain magnetic resonance imaging (MRI) was performed for all patients. Results:  Of the 300 patients with suspected ON, 191 were eventually diagnosed as ON, and 66 (35%) of them had a previous diagnosis or were diagnosed with multiple sclerosis (MS). Of the 125 patients without MS diagnosis, 62 (50%) had demyelinative lesions in MRI, which is a risk factor for developing MS. Two patients (1.1%; 95% CI 0.3–4.5) fulfilled the criteria of NMO. Positive AQP4 antibodies were found in three patients (1.6% 95% CI 0.3–4.5), one of them had NMO, one had MS and one became diagnosed with MS a month later. Borderline autoantibody levels were found in 10 patients, 7 of whom had MS. Conclusions:  NMO is rare among ON patients in the population of Southern Finland. In this small cohort, the sensitivity and positive predictive values of the AQP4 autoantibody index for NMO were low, 1/2 and 1/3 respectively, and do not support initiating routine screening.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>23773223</pmid><doi>10.1111/aos.12187</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aquaporin 4 - immunology
Aquaporins
aquaporin‐4 autoantibody
Autoantibodies - blood
Autoantigens - immunology
autoimmune optic neuropathy
Enzyme-Linked Immunosorbent Assay
Female
Finland - epidemiology
Humans
Magnetic Resonance Imaging
Male
Medical research
Middle Aged
Multiple sclerosis
neuromyelitis optica
Neuromyelitis Optica - diagnosis
Neuromyelitis Optica - epidemiology
Neuromyelitis Optica - immunology
NMR
Nuclear magnetic resonance
Ophthalmology
optic neuritis
Optic Neuritis - diagnosis
Optic Neuritis - epidemiology
Optic Neuritis - immunology
Radioimmunoprecipitation Assay
Young Adult
title Neuromyelitis optica and aquaporin‐4 (AQP4) autoantibodies in consecutive optic neuritis patients in Southern Finland
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