nach oben

Erschienen in:

16.05.2023 | Original Article

Establishment of a comprehensive diagnostic model for neuromyelitis optica spectrum disorders based on the analysis of laboratory indicators and clinical data

verfasst von: Wencan Jiang, Xiaoxuan Yin, Yufei Wang, Yaowei Ding, Yu Pan, Guanghui Zheng, Hong Lv, Kelin Chen, Siwen Li, Lijuan Wang, Yijun Shi, Guoge Li, Guojun Zhang

Erschienen in: Neurological Sciences | Ausgabe 10/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

To establish a comprehensive diagnostic model for neuromyelitis optica spectrum disorders (NMOSDs) based on laboratory indicators and clinical data.

Methods

A retrospective method was used to query the medical records of patients with NMOSD from January 2019 to December 2021. At the same time, clinical data of other neurological diseases were also collected for comparison. Clinical data of the NMOSD group and non-NMOSD group were analyzed, and the diagnostic model was established based on these data. In addition, the model was evaluated and verified by the receiver operating curve.

Results

A total of 73 patients with NMOSD were included, and the ratio of males to females was 1:3.06. The indicators that showed differences between the NMOSD group and non NMOSD group included neutrophils (P = 0.0438), PT (P = 0.0028), APTT (P < 0.0001), CK (P = 0.002), IBIL (P = 0.0181), DBIL (P < 0.0001), TG (P = 0.0078), TC (P = 0.0117), LDL-C (P = 0.0054), ApoA1 (P = 0.0123), ApoB (P = 0.0217), TPO antibody (P = 0.012), T3 (P = 0.0446), B lymphocyte subsets (P = 0.0437), urine sg (P = 0.0123), urine pH (P = 0.0462), anti-SS-A antibody (P = 0.0036), RO-52 (P = 0.0138), CSF simplex virus antibody I-IGG (P = 0.0103), anti-AQP4 antibody (P < 0.0001), and anti-MOG antibody (P = 0.0036). Logistic regression analysis showed that changes in ocular symptoms, anti-SSA antibody, anti-TPO antibody, B lymphocyte subsets, anti-AQP4 antibody, anti-MOG antibody, TG, LDL, ApoB, and APTT had a significant impact on diagnosis. The AUC of the combined analysis was 0.959. The AUC of the new ROC for AQP4- and MOG- antibody negative NMOSD was 0.862.

Conclusions

A diagnostic model was successfully established, which can play an important role in differential diagnosis of NMOSD.

Nur mit Berechtigung zugänglich

Du Y, Li K, Liu W, Song R, Luo M, He J et al (2022) Recent advances in neuromyelitis optica spectrum disorder: pathogenesis, mechanisms and potential treatments. Curr Pharm Des 28:272–279CrossRefPubMed

Cruz RA, Chaudhary S, Guevara M, Meltzer E (2021) Neuromyelitis optica spectrum disorders (NMOSD) and connective tissue disease (CTD): an update for the rheumatologist. Curr Rheumatol Rep 23:33CrossRefPubMed

Shahmohammadi S, Doosti R, Shahmohammadi A, Azimi A, Sahraian MA, Fattahi MR et al (2021) Neuromyelitis optica spectrum disorder (NMOSD) associated with cancer: a systematic review. Mult Scler Relat Disord 56:103227CrossRefPubMed

Huda S, Whittam D, Bhojak M, Chamberlain J, Noonan C, Jacob A (2019) Neuromyelitis optica spectrum disorders. Clin Med (Lond) 19:169–176CrossRefPubMed

Marignier R, Bennett JL, Kim HJ, Weinshenker BG, Pittock SJ, Wingerchuk D et al (2021) Disability outcomes in the N-MOmentum trial of inebilizumab in neuromyelitis optica spectrum disorder. Neurol Neuroimmunol Neuroinflamm 8:e978CrossRefPubMedPubMedCentral

Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T et al (2015) International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85(2):177–189CrossRefPubMedPubMedCentral

Borisow N, Mori M, Kuwabara S, Scheel M, Paul F (2018) Diagnosis and treatment of NMO spectrum disorder and MOG-encephalomyelitis. Front Neurol 9:888CrossRefPubMedPubMedCentral

Jarius S, Paul F, Aktas O, Asgari N, Dale RC, de Seze J et al (2018) MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. J Neuroinflammation 15:134CrossRefPubMedPubMedCentral

Prasad S, Chen J (2019) What you need to know about AQP4, MOG, and NMOSD. Semin Neurol 39:718–731CrossRefPubMed

10.

Denève M, Biotti D, Patsoura S, Ferrier M, Meluchova Z, Mahieu L et al (2019) MRI features of demyelinating disease associated with anti-MOG antibodies in adults. J Neuroradiol 46:312–318CrossRefPubMed

11.

Fujihara K (2019) Neuromyelitis optica spectrum disorders: still evolving and broadening. Curr Opin Neurol 32:385–394CrossRefPubMedPubMedCentral

12.

Holroyd KB, Manzano GS, Levy M (2020) Update on neuromyelitis optica spectrum disorder. Curr Opin Ophthalmol 31:462–468CrossRefPubMedPubMedCentral

13.

Levy M, Fujihara K, Palace J (2021) New therapies for neuromyelitis optica spectrum disorder. Lancet Neurol 20:60–67CrossRefPubMed

14.

Wang Y, Chang H, Zhang X, Yin L (2021) Efficacy of rituximab in the treatment of neuromyelitis optica spectrum disorders: an update systematic review and meta -analysis. Mult Scler Relat Disord 50:102843CrossRefPubMed

15.

Carnero Contentti E, Correale J (2021) Neuromyelitis optica spectrum disorders: from pathophysiology to therapeutic strategies. J Neuroinflammation 18:208CrossRefPubMedPubMedCentral

16.

Pittock SJ, Zekeridou A, Weinshenker BG (2021) Hope for patients with neuromyelitis optica spectrum disorders - from mechanisms to trials. Nat Rev Neurol 17:759–773CrossRefPubMed

17.

Leonhard SE, Mandarakas MR, Gondim FAA, Bateman K, Ferreira MLB, Cornblath DR et al (2019) Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol 15:671–683CrossRefPubMedPubMedCentral

18.

Shahrizaila N, Lehmann HC, Kuwabara S (2021) Guillain-Barré syndrome. Lancet 397:1214–1228CrossRefPubMed

19.

Klineova S, Lublin FD (2018) Clinical course of multiple sclerosis. Cold Spring Harb Perspect Med 8:a028928CrossRefPubMedPubMedCentral

20.

Athar T, Al Balushi K, Khan SA (2021) Recent advances on drug development and emerging therapeutic agents for Alzheimer’s disease. Mol Biol Rep 48:5629–5645CrossRefPubMedPubMedCentral

21.

Ferrari C, Sorbi S (2021) The complexity of Alzheimer’s disease: an evolving puzzle. Physiol Rev 101:1047–1081CrossRefPubMed

22.

Bohmwald K, Andrade CA, Gálvez NMS, Mora VP, Muñoz JT, Kalergis AM (2021) The causes and long-term consequences of viral encephalitis. Front Cell Neurosci 15:755875CrossRefPubMedPubMedCentral

23.

Abboud H, Probasco JC, Irani S, Ances B, Benavides DR, Bradshaw M et al (2021) Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management. J Neurol Neurosurg Psychiatry 92:757–768CrossRefPubMed

24.

Dutra BG, da Rocha AJ, Nunes RH, Maia ACMJ (2018) Neuromyelitis optica spectrum disorders: spectrum of MR imaging findings and their differential diagnosis. Radiographics 38:169–193CrossRefPubMed

25.

Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG (2007) The spectrum of neuromyelitis optica. Lancet Neurol 6:805–815CrossRefPubMed

26.

Ibis SC, Omaira M, Arnoldo S, Elizabeth A, Sandra M, Carlota CM et al (2021) Epidemiological findings of neuromyelitis optica spectrum disorders in a Venezuelan study. Mult Scler Relat Disord 47:102652CrossRefPubMed

27.

Tani J, Liao HT, Hsu HC, Chen LF, Chang TS, Shin-Yi Lin C et al (2020) Immune-mediated axonal dysfunction in seropositive and seronegative primary Sjögren’s syndrome. Ann Clin Transl Neurol 7:819–828CrossRefPubMedPubMedCentral

28.

Li H, Dai Y, Wu AM, Sun X, Lin Y, Lv K et al (2015) Anti-thyroid antibodies and cerebrospinal fluid findings in neuromyelitis optica spectrum disorders. J Neuroimmunol 281:38–43CrossRefPubMed

29.

Habe K, Wada H, Mizutani K, Matsushima Y, Kondo M, Yamanaka K (2021) The clinical significance of a shortened activated partial thromboplastin time in patients with connective tissue disease. Clin Rheumatol 40:4675–4683CrossRefPubMed

30.

Verhamme P, Yi BA, Segers A, Salter J, Bloomfield D, Büller HR et al (2021) Abelacimab for prevention of venous thromboembolism. N Engl J Med 385:609–617CrossRefPubMed

31.

Branchford BR, Carpenter SL (2018) The role of inflammation in venous thromboembolism. Front Pediatr 6:142CrossRefPubMedPubMedCentral

32.

Wu K, Wen L, Duan R, Li Y, Yao Y, Jing L et al (2019) Triglyceride level is an independent risk factor in first-attacked neuromyelitis optica spectrum disorders patients. Front Neurol 10:1230CrossRefPubMedPubMedCentral

33.

Sasabe N, Keyamura Y, Obama T, Inoue N, Masuko Y, Igarashi Y et al (2014) Time course-changes in phosphatidylcholine profile during oxidative modification of low-density lipoprotein. Lipids Health Dis 13:48CrossRefPubMedPubMedCentral

34.

Itabe H, Sawada N, Makiyama T, Obama T (2021) Structure and dynamics of oxidized lipoproteins in vivo: roles of high-density lipoprotein. Biomedicines 9:655CrossRefPubMedPubMedCentral

35.

Lee JJ, Chi G, Fitzgerald C, Kazmi SHA, Kalayci A, Korjian S et al (2021) Cholesterol efflux capacity and its association with adverse cardiovascular events: a systematic review and meta-analysis. Front Cardiovasc Med 8:774418CrossRefPubMedPubMedCentral

36.

Cencioni MT, Mattoscio M, Magliozzi R, Bar-Or A, Muraro PA (2021) B cells in multiple sclerosis - from targeted depletion to immune reconstitution therapies. Nat Rev Neurol 17:399–414CrossRefPubMed

37.

Etemadifar M, Salari M, Mirmosayyeb O, Serati M, Nikkhah R, Askari M et al (2017) Efficacy and safety of rituximab in neuromyelitis optica: review of evidence. J Res Med Sci 22:18CrossRefPubMedPubMedCentral

38.

Narayan R, Simpson A, Fritsche K, Salama S, Pardo S, Mealy M et al (2018) MOG antibody disease: a review of MOG antibody seropositive neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 25:66–72CrossRefPubMed

39.

Chen ZG, Huang J, Fan R, Weng RH, Shinohara RT, Landis JR et al (2020) Urinalysis in patients with neuromyelitis optica spectrum disorder. Eur J Neurol 27:619–625CrossRefPubMed

Titel: Establishment of a comprehensive diagnostic model for neuromyelitis optica spectrum disorders based on the analysis of laboratory indicators and clinical data
verfasst von: Wencan Jiang
Xiaoxuan Yin
Yufei Wang
Yaowei Ding
Yu Pan
Guanghui Zheng
Hong Lv
Kelin Chen
Siwen Li
Lijuan Wang
Yijun Shi
Guoge Li
Guojun Zhang
Publikationsdatum: 16.05.2023
Verlag: Springer International Publishing
Erschienen in: Neurological Sciences / Ausgabe 10/2023
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-023-06853-2

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Wartezeit nicht kürzer, aber Arbeit flexibler

Psychotherapie Medizin aktuell

Fünf Jahren nach der Neugestaltung der Psychotherapie-Richtlinie wurden jetzt die Effekte der vorgenommenen Änderungen ausgewertet. Das Hauptziel der Novellierung war eine kürzere Wartezeit auf Therapieplätze. Dieses Ziel wurde nicht erreicht, es gab jedoch positive Auswirkungen auf andere Bereiche.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Establishment of a comprehensive diagnostic model for neuromyelitis optica spectrum disorders based on the analysis of laboratory indicators and clinical data