The detection of antibodies against aquaporin-4 (AQP4) has improved the diagnosis of neuromyelitis optica (NMO). We evaluated a recently established cell-based anti-AQP4 assay in 273 patients with inflammatory CNS demyelination. The assay had a specificity of 99% and a sensitivity of 56% to detect all NMO patients and of 74% to detect the recurrent NMO patients, similar to the initial studies reported. AQP4 antibodies were absent in monophasic NMO patients, while samples in recurrent cases remained positive during follow-up. We conclude that the pathogenesis of monophasic NMO may be different from that of relapsing NMO.
LennonVAWingerchukDMKryzerTJ. A serum autoantibody marker of neuromyelitis optica: Distinction from multiple sclerosis. Lancet2004; 364: 2106–2112.
2.
LennonVAKryzerTJPittockSJVerkmanASHinsonSR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exper Med2005; 202: 473–477.
3.
WingerchukDMLennonVALucchinettiCFPittockSJWeinshenkerBG. The spectrum of neuromyelitis optica. Lancet Neurol2007; 6: 805–815.
4.
SellnerJBoggildMClanetM. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol2010; 17: 1019–1032.
5.
WingerchukDMLennonVAPittockSJLucchinettiCFWeinshenkerBG. Revised diagnostic criteria for neuromyelitis optica. Neurology2006; 66: 1485–1489.
6.
PolmanCHReingoldSCEdanG. Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘McDonald Criteria’. Ann Neurol2005; 58: 840–846.
7.
WatersPJariusSLittletonE. Aquaporin-4 antibodies in neuromyelitis optica and longitudinally extensive transverse myelitis. Arch Neurol2008; 65: 913–919.
8.
JariusSWildemannB. AQP4 antibodies in neuromyelitis optica: Diagnostic and pathogenetic relevance. Nat Rev Neurol2010; 6: 383–392.
