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. 2011 May 3;76(18):1589-95.
doi: 10.1212/WNL.0b013e3182190f74.

A population-based study of neuromyelitis optica in Caucasians

N Asgari  1 , S T Lillevang, H P B Skejoe, M Falah, E Stenager, K O Kyvik
Affiliations

A population-based study of neuromyelitis optica in Caucasians

N Asgari et al. Neurology. .

Abstract

Background: Epidemiologic studies have suggested different prevalence of neuromyelitis optica (NMO) in different ethnic groups. However, data on the incidence and prevalence of NMO in Caucasians are scarce.

Objective: To estimate the incidence and prevalence of NMO in a predominantly Caucasian population based on the Wingerchuk 2006 criteria.

Methods: The study was a population-based retrospective case series with longitudinal follow-up. Patients with multiple sclerosis (MS), optic neuritis (ON), acute transverse myelitis (TM), and NMO from the 4 neurology and 3 ophthalmology departments in the Region of Southern Denmark having been diagnosed between 1998 and 2008 were investigated. Patients were included based on 1) episodes of ON or TM and 2) an initial brain MRI not diagnostic for MS. An immunofluorescence assay was used to determine aquaporin-4 (AQP-4) antibodies.

Results: A total of 477 patients with MS, TM, or ON were evaluated: 163 fulfilled the inclusion criteria, 42 (26%) qualified for the diagnosis of NMO, 26 (62.0%) of these were AQP4 antibody positive. All except one were Caucasian, the female:male ratio was 2.8:1, and mean age at onset was 35.6 years (range 15-64 years). The clinical presentation was heterogeneous including TM, longitudinally extensive TM, ON, and brainstem syndromes. The yearly incidence rate of NMO in the population was estimated to be 0.4 per 10(5) person-years (95% confidence interval [CI] 0.30-0.54) and the prevalence was 4.4 per 10(5) (95% CI 3.1-5.7).

Conclusions: Despite being a rare disease, NMO is more common in a Caucasian population than earlier believed.

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Figures

Figure
Figure. Flow chart of the diagnosis of neuromyelitis optica (NMO) in the study
The figure shows the diagnostic process of the selected study population. The clinical data and the imaging data were prepared to establish the clinical NMO diagnosis without knowledge of the aquaporin-4 (AQP4) antibody serologic status. The AQP4 antibodies were measured without knowledge of the clinical status. As an endpoint, the final diagnosis of NMO was made. *Number of patients where the diagnosis depended on AQP4 antibody positivity. MS = multiple sclerosis; ON = optic neuritis; TM = transverse myelitis.
See this image and copyright information in PMC

References

    1. Lucchinetti CF, Mandler RN, McGavern D, et al. A role for humoral mechanisms in the pathogenesis of Devic's neuromyelitis optica. Brain 2002;125:1450–1461 - PMC - PubMed
    1. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol 2007;6:805–815 - PubMed
    1. Jacob A, Matiello M, Wingerchuk DM, Lucchinetti CF, Pittock SJ, Weinshenker BG. Neuromyelitis optica: changing concepts. J Neuroimmunol 2007;187:126–138 - PubMed
    1. Asgari N, Owens T, Frokiaer J, Stenager E, Lillevang ST, Kyvik KO. Neuromyelitis optica (NMO): an autoimmune disease of the central nervous system (CNS). Acta Neurol Scand Epub 2010 Sep 29. - PubMed
    1. Wingerchuk DM, Hogancamp WF, O'Brien PC, Weinshenker BG. The clinical course of neuromyelitis optica (Devic's syndrome). Neurology 1999;53:1107–1114 - PubMed

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