Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T06:17:27.550Z Has data issue: false hasContentIssue false
  • English
  • Français

Frequency of autoimmune disorders and autoantibodies in patients with neuromyelitis optica

Published online by Cambridge University Press:  03 October 2016

Wildéa Lice de Carvalho Jennings Pereira ,
Edna Maria Vissoci Reiche ,
Ana Paula Kallaur ,
Sayonara Rangel Oliveira ,
Andréa Name Colado Simão ,
Marcell Alysson Batisti Lozovoy ,
Lucas José Vaz Schiavão ,
Paula Raquel do Vale Pascoal Rodrigues ,
Daniela Frizon Alfieri  and
Tamires Flauzino
...Show all authors
Wildéa Lice de Carvalho Jennings Pereira
Affiliation:
Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Edna Maria Vissoci Reiche*
Affiliation:
Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Ana Paula Kallaur
Affiliation:
Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Sayonara Rangel Oliveira
Affiliation:
Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Andréa Name Colado Simão
Affiliation:
Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Marcell Alysson Batisti Lozovoy
Affiliation:
Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Lucas José Vaz Schiavão
Affiliation:
Neurology Outpatient Department of the Outpatient Specialties of University Hospital, State University of Londrina, Londrina, Paraná, Brazil
Paula Raquel do Vale Pascoal Rodrigues
Affiliation:
Neurology Outpatient Department of the Outpatient Specialties of University Hospital, State University of Londrina, Londrina, Paraná, Brazil
Daniela Frizon Alfieri
Affiliation:
Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Tamires Flauzino
Affiliation:
Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
Damacio Ramón Kaimen-Maciel
Affiliation:
Neurology Outpatient Department of the Outpatient Specialties of University Hospital, State University of Londrina, Londrina, Paraná, Brazil Department of Clinical Medicine, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
*
Edna Maria Vissoci Reiche, Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, Londrina State University, Av. Robert Koch, 60, 86.038-350, Londrina, Paraná, Brazil. Tel: +55 43 3371 2619; Fax: +55 43 3371 2619; E-mail: reiche@sercomtel.com.br
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The aim of this study was to report the frequency of autoimmune disorders and autoantibodies in 22 patients with neuromyelitis optica (NMO), as well as whether the seropositivity for autoantibodies differs between anti-aquaporin 4 (AQP4) positive and AQP4 negative NMO patients.

Methods

Demographic, medical records, and a profile of autoantibodies were evaluated in 22 NMO patients, including AQP4, anti-thyroid-stimulating hormone receptor, antinuclear antibodies (ANA), anti-thyroperoxidase (anti-TPO), anti-thyroglobulin (anti-Tg), anti-double-stranded DNA, anti-neutrophil cytoplasmic, anti-cyclic citrullinate peptide, rheumatoid factor, anti-SSA/Ro, anti-SSB/La, anti-Smith antibodies (anti-Sm), anti-ribonucleoprotein, anti-nucleosome, and anti-Scl70. Thyroid-stimulating hormone and free thyroxin were measured.

Results

The frequency of women was higher than men (95.5% vs. 4.5%) and 68.2% were Afro-Brazilians. Six (27.3%) patients presented other autoimmune disorders, such as Hashimoto thyroiditis (n=2), Graves’ disease (n=1), juvenile idiopathic arthritis (n=1), systemic lupus erythematosus and systemic sclerosis (n=1), and Raynaud’s phenomenon (n=1). The most frequent autoantibodies were anti-AQP4 (54.5%), anti-nucleosome (31.8%), ANA (27.3%), anti-TPO (22.7%), and anti-Tg (22.7%). Difference was not observed in the frequency of autoimmune disorders when the patients were compared according to their anti-AQP4 status.

Conclusion

The results of the present study underscored that the NMO patients present high frequency of autoantibodies against cellular antigens and the presence of autoimmune disorders. Further studies with large number of NMO patients may contribute to advances in the understanding of NMO disease mechanisms.

Keywords

anti-aquaporin 4autoimmune thyroiditisautoimmunityjuvenile idiopathic arthritisneuromyelitis optica
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 29 , Issue 3 , June 2017 , pp. 170 - 178
Check for updates
Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Sellner, J, Hemmer, B, Mühlau, M. The clinical spectrum and immunobiology of parainfectious neuromyelitis optica (Devic) syndromes. J Autoimmun 2010;34:371–379.Google Scholar
2. Jacob, A, Matiello, M, Wingerchuk, DM, Lucchinetti, CF, Pittock, SJ, Weinshenker, BG. Neuromyelitis optica: changing concepts. J Neuroimmunol 2007;187:126–138.CrossRefGoogle ScholarPubMed
3. Matiello, M, Jacob, A, Wingerchuk, D, Weinshenker, BG. Neuromyelitis optica. Curr Opin Neurol 2007;20:255–260.CrossRefGoogle ScholarPubMed
4. Kim, W, Kim, SH, Kim, HJ. New insights into neuromyelitis optica. J Clin Neurol 2011;7:115–127.Google Scholar
5. Jarius, S, Wildemann, B. The history of neuromyelitis optica. J Neuroinflammation 2013;10:1–12.Google Scholar
6. Wingerchuk, DM, Lennon, VA, Lucchinetti, CF, Pittock, SJ, Weinshenker, BG. The spectrum of neuromyelitis optica. Lancet Neurol 2007;6:805–815.Google Scholar
7. Jarius, S, Jacobi, C, De Seze, J et al. Frequency and syndrome specificity of antibodies to aquaporin-4 in neurological patients with rheumatic disorders. Mult Scler 2011;17:1067–1073.Google Scholar
8. Lennon, VA, Kryzer, TJ, Pittock, SJ, Verkman, AS, Hinson, SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005;202:473–477.Google Scholar
9. Brusse, E, Tijssen, C. Neuromyelitis optica with endocrinopathy: further evidence of a new syndrome. J Neuroophthalmol 2001;25:151–155.Google Scholar
10. Sergio, P, Mariana, B, Alberto, O et al. Association of neuromyelitis optica (NMO) with autoimmune disorders: report of two cases and review of the literature. Clin Rheumatol 2010;29:1335–1338.Google Scholar
11. Asgari, N, Owens, T, Frøkiaer, J, Stenager, E, Lillevang, ST, Kyvik, KO. Neuromyelitis optica (NMO) – an autoimmune disease of the central nervous system (CNS). Acta Neurol Scand 2011;123:369–384.Google Scholar
12. Fujihara, K. Neuromyelitis optica and astrocytic damage in its pathogenesis. J Neurol Sci 2011;306:183–187.Google Scholar
13. Jarius, S, Paul, F, Franciotta, D et al. Neuromyelitis optica spectrum disorders in patients with myasthenia gravis: ten new aquaporin-4 antibody positive cases and a review of the literature. Mult Scler 2012;18:1135–1144.Google Scholar
14. Leite, MI, Coutinho, E, Lana-Peixoto, M et al. Myasthenia gravis and neuromyelitis optica spectrum disorder: a multicenter study of 16 patients. Neurology 2012;78:1601–1607.Google Scholar
15. Maruta, K, Sonoda, Y, Uchida, Y, Takahashi, T, Fukunaga, H. A case of neuromyelitis optica associated with anti-aquaporin 4 antibody and other autoantibodies. Nihon Ronen Igakkai Zasshi 2012;49:491–495.CrossRefGoogle ScholarPubMed
16. Wingerchuk, DM, Weinshenker, BG. The emerging relationship between neuromyelitis optica and systemic rheumatologic autoimmune disease. Mult Scler 2012;18:5–10.Google Scholar
17. Sato, DK, Lana-Peixoto, M, Fujihara, K, De Seze, J. Clinical spectrum and treatment of neuromyelitis optica spectrum disorders: evolution and current status. Brain Pathol 2013;23:647–660.Google Scholar
18. Freitas, E, Guimarães, J. Neuromyelitis optica spectrum disorders associated with other autoimmune diseases. Rheumatol Int 2014;35:243–253.Google Scholar
19. Zhang, B, Zhong, Y, Wang, Y et al. Neuromyelitis optica spectrum disorders without and with autoimmune diseases. BMC Neurol 2014;14:162.Google Scholar
20. Pittock, SJ, Lennon, VA, De Seze, J et al. Neuromyelitis optica and organ-specific autoimmunity. Arch Neurol 2008;65:78–83.Google Scholar
21. Uzawa, A, Mori, M, Sawai, S et al. Cerebrospinal fluid interleukin-6 and glial fibrillary acidic protein levels are increased during initial neuromyelitis optica attacks. Clin Chim Acta 2013;421:181–183.Google Scholar
22. Nagaishi, A, Takagi, M, Umemura, A et al. Clinical features of neuromyelitis optica in a large Japanese cohort: comparison between phenotypes. J Neurol Neurosurg Psychiatry 2011;82:1360–1364.Google Scholar
23. Wingerchuk, DM, Lennon, VA, Pittock, SJ, Lucchinetti, CF, Weinshenker, BG. Revised diagnostic criteria for neuromyelitis optica. Neurology 2006;66:1485–1489.Google Scholar
24. Hochberg, MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.Google Scholar
25. Shiboski, SC, Shiboski, CH, Criswell, L et al. American College Rheumatology classification criteria for Sjogren’s syndrome: a data-driven, expert consensus approach in the Sjogren’s International Collaborative Clinical Alliance cohort. Arthritis Care Res 2012;64:475–487.Google Scholar
26. Aletaha, D, Neogi, T, Silman, A et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis Rheum 2010;62:2569–2581.Google Scholar
27. Petty, RE, Southwood, TR, Manners, P et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004;31:390–392.Google Scholar
28. Kurtzke, JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983;33:1444–1452.Google Scholar
29. Kayser, C, Corrêa, MJU, Andrade, LEC. Raynaud’s phenomenon. Rev Bras Reumatol 2009;49:48–63.Google Scholar
30. D’cruz, DP, Mellor-Pita, S, Joven, B et al. Transverse myelitis as the first manifestations of systemic lupus erythematosus or lupus-like disease: good functional outcome and relevance of antiphospholipid antibodies. J Rheumatol 2004;31:280–285.Google ScholarPubMed
31. Birnbaum, J, Kerr, D. Devic’s syndrome in a woman with systemic lupus erythematosus: diagnostic and therapeutic implications of testing for the neuromyelitis optica IgG autoantibody. Arthritis Rheum 2007;57:347–351.Google Scholar
32. Franciotta, D, Zardini, E, Caporali, R et al. Systemic sclerosis in aquaporin-4 antibody-positive longitudinally extensive transverse myelitis. J Neurol Sci 2011;303:139–141.Google Scholar
33. Mihailova, D, Grigorova, R, Vassileva, B et al. Autoimmune thyroid disorders in juvenile chronic arthritis and systemic lupus erythematosus. Adv Exp Med Biol 1999;455:55–60.Google Scholar
34. Alpigiani, MG, Cerboni, M, Bertini, I et al. Endocrine autoimmunity in young patients with juvenile chronic arthritis. Clin Exp Rheumatol 2002;20:565–568.Google Scholar
35. Stagi, S, Giani, T, Simonini, G, Falcini, F. Thyroid function, autoimmune thyroiditis and coeliac disease in juvenile idiopathic arthritis. Rheumatology 2005;44:517–520.CrossRefGoogle ScholarPubMed
36. Mckeon, A, Lennon, VA, Lotze, T et al. CNS aquaporin-4 autoimmunity in children. Neurology 2008;71:93–100.Google Scholar
37. Jarius, S, Ruprecht, K, Wildemann, B et al. Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: a multicentre study of 175 patients. J Neuroinflammation 2012;9:14.Google Scholar
38. Kallaur, AP, Oliveira, SR, Simão, AN et al. Tumor necrosis factor beta (TNF-β) NcoI polymorphism is associated with multiple sclerosis in Caucasian patients from Southern Brazil independently from HLA-DRB1. J Mol Neurosci 2014;53:211–221.Google Scholar
39. Lana-Peixoto, MA. Devic’s neuromyelitis optica: a critical review. Arq Neuropsiquiatr 2008;66:120–138.Google Scholar
40. Flanagan, EP, Cabre, P, Weinshenker, BG et al. Epidemiology of aquaporin-4 autoimmunity and neuromyelitis optica spectrum. Ann Neurol 2016. doi:10.1002/ana.24617.Google Scholar
41. Rivera, JF, Kurtzke, JF, Booth, VJA, Corona, VT 5th . Characteristics of Devic’s disease (neuromyelitis optica) in Mexico. J Neurol 2008;255:710–715.Google Scholar
42. Grimaldi, CM. Sex and systemic lupus erythematosus: the role of the sex hormones estrogen and prolactin on the regulation of autoreactive B cells. Curr Opin Rheumatol 2006;18:456–461.Google Scholar
43. Wingerchuk, DM. Neuromyelitis optica: effect of gender. J Neurol Sci 2009;286:13–18.Google Scholar
44. Matà, S, Lolli, F. Neuromyelitis optica: an update. J Neurol Sci 2011;303:13–21.Google Scholar
45. Adoni, T, Lino, AM, Marchiori, PE, Kok, F, Callegaro, D. Seroprevalence of NMO-IgG antibody in Brazilian patients with neuromyelitis optica. Arq Neuropsiquiatr 2008;66:295–297.Google Scholar
46. Graber, DJ, Levy, M, Kerr, D, Wade, WF. Neuromyelitis optica pathogenesis and aquaporin 4. J Neuroinflammation 2008;29:5–22.Google Scholar
47. Takahashi, T, Fujihara, K, Nakashima, I et al. Anti-aquaporin-4 antibody is involved in the pathogenesis of NMO: a study on antibody titre. Brain 2007;130:1235–1243.Google Scholar
48. Jarius, S, Aboul-Enein, F, Waters, P et al. Antibody to aquaporin-4 in the long-term course of neuromyelitis optica. Brain 2008;131:3072–3080.Google Scholar
49. Ducray, F, Roos-Weil, R, Garcia, PY et al. Devic’s syndrome-like phenotype associated with thymoma and anti-CV2/CRMP5 antibodies. J Neurol Neurosurg Psychiatry 2007;78:325–327.CrossRefGoogle ScholarPubMed
50. Silber, MH, Willcox, PA, Bowen, RM, Unger, A. Neuromyelitis optica (Devic’s syndrome) and pulmonary tuberculosis. Neurology 1990;40:934–938.Google Scholar
51. Sridhar, S, Chan, JF, Yuen, KY. Fatal anti-aquaporin-4 seropositive neuromyelitis optical spectrum disorder in tuberculosis. BMC Infect Dis 2014;14:470.Google Scholar
52. Blanche, P, Diaz, E, Goert, B, Sicard, D, Rivoal, O, Brezin, A. Devic’s neuromyelitis optica and HIV-1 infection. J Neurol Neurosurg Psychiatry 2000;68:795–796.Google Scholar
53. Machado, C, Amorim, J, Rocha, J, Pereira, J, Lourenço, E, Pinho, J. Neuromyelitis optica spectrum disorder and varicella-zoster infection. J Neurol Sci 2015;358:520–521.Google Scholar
54. Feng, YQ, Guo, N, Huang, F, Chen, X, Sun, QS, Liu, JX. Anti-tuberculosis treatment for Devic’s neuromyelitis optica. J Clin Neurosci 2010;17:1372–1377.Google Scholar
55. Ciufreda, D, Pantaleo, G, Pascual, M. Effects of immunosuppressive drugs on HIV infection: implications for solid-organ transplantation. Transpl Int 2007;20:649–658.Google Scholar
56. Feyissa, AM, Singh, P, Smith, RG. Neuromyelitis optica in patients with coexisting human immunodeficiency virus infections. Mult Scler 2013;19:1363–1366.Google Scholar
57. Salazar, R, Cerghet, M, Shad, A, Markowitz, NP. NMO-IgG positive relapsing longitudinally extensive transverse myelitis (LETM) in a seropositive HIV patient. Clin Neurol Neurosur 2013;115:1873–1875.Google Scholar