好色先生

好色先生

Explore the latest content from across our publications

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

A Population-Based Study of Idiopathic Transverse Myelitis with Aquaporin-4-IgG and Myelin-Oligodendrocyte-Glycoprotein-IgG Assessment
Autoimmune Neurology
S11 - Autoimmune CNS Inflammatory Disorders: Clinical Advances (4:36 PM-4:47 PM)
007

ITM is considered a distinct, homogeneous subgroup of inflammatory TM of unclear etiology. Prior studies have variably estimated ITM incidence between 1 and 6.2/million but they precede AQP4-IgG and MOG-IgG discovery.


To determine the epidemiology and characteristics of idiopathic transverse myelitis (ITM) in the era of aquaporin-4 (AQP4)-IgG and myelin-oligodendrocyte-glycoprotein (MOG)-IgG disease-associated TM.


We performed a population-based study of ITM incidence (2003-2016), prevalence (December 31, 2016) and characteristics in Olmsted County, Minnesota. ITM was defined by 2002 TM consortium diagnostic criteria. Serum was available for testing AQP4-IgG and MOG-IgG in 28/30 (93%) and 26/30 (87%) patients initially meeting ITM criteria: 4 incident (17%: AQP4-IgG, 2; MOG-IgG, 2) and 3 prevalent (16%; AQP4-IgG, 2; MOG-IgG, 1) ITM patients were consequently excluded and reclassified as disease-associated TM. All had TM characteristics consistent with AQP4-/MOG-IgG associated disorders including: LETM, 4/4 (100%); CSF pleocytosis, 4/4 (100%); and absence of oligoclonal bands, 3/4 (75%).


The ITM incidence was 9.5/1,000,000 and prevalence was 10.4/100,000. Median age of ITM onset was 40.5 years (range, 9-72) and 16 (62%) were female. Median EDSS at nadir was 2.5 (range, 0-8). Cerebrospinal fluid (CSF) findings included elevated white blood cell count, 7/22 (32%); and positive oligoclonal bands, 4/19 (21%). MRI spine revealed LETM in 4/25 (16%), gadolinium enhancement in 20/25 (80%) and ≥2 spinal cord lesions in 6/25 (24%). Five ITM patients (19%) converted to MS during a median follow-up of 53 months (range, 0.5-400), three with subsequent relapses and 2 with development of brain MRI lesions.


ITM incidence and prevalence were modestly reduced by the availability of AQP4-IgG and MOG-IgG testing, but remained higher than prior reports.  Future updates of ITM diagnostic criteria are needed to account for AQP4-IgG and MOG-IgG discovery and for the clinical and MRI heterogeneity which characterize ITM cases.


Authors/Disclosures
Elia Sechi, MD (University of Sassari)
PRESENTER
Dr. Sechi has nothing to disclose.
Eslam H. Shosha, MD (KKH-College of Medicine-Majmaah University) Dr. Shosha has nothing to disclose.
No disclosure on file
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology) Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. The institution of Dr. Pittock has received research support from Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from F. Hoffman/LaRoche/Genentech. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
Brian G. Weinshenker, MD, FAAN (University of Virginia Health System) Dr. Weinshenker has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CANbridge Pharmaceuticals. Dr. Weinshenker has received personal compensation in the range of $0-$499 for serving as a Consultant for CALIBR. Dr. Weinshenker has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Weinshenker has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Weinshenker has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Group (Chugai, Genentech, Roche). Dr. Weinshenker has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharmaceuticals. Dr. Weinshenker has received research support from Guthy Jackson Charitable Foundation. Dr. Weinshenker has received intellectual property interests from a discovery or technology relating to health care.
Mark Keegan, MD, FAAN (Mayo Clinic) Dr. Keegan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Keegan has received publishing royalties from a publication relating to health care. Dr. Keegan has received publishing royalties from a publication relating to health care.
Nicholas L. Zalewski, MD (Mayo Clinic) Dr. Zalewski has nothing to disclose.
No disclosure on file
Jiraporn Jitprapaikulsan, MD (Faculty of Medicine Siriraj Hospital) Dr. Jitprapaikulsan has nothing to disclose.
Eoin P. Flanagan, MBBCh, FAAN (Mayo Clinic) The institution of Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. The institution of Dr. Flanagan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pharmacy times. The institution of Dr. Flanagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Flanagan has received research support from Viela Bio. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Roche. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has a non-compensated relationship as a Member of medical Advisory Board with The MOG Project that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Journal of The Neurologic Sciences that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Neuroimmunology Reports that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology, Neuroimmunology Neuroinflammation (N2) Journal that is relevant to AAN interests or activities.