Objective: To analyze the clinical features and brain, spinal cord magnetic resonance imaging (MRI) features of neuromyelitis optical (NMO) patients with positive anti-nuclear antibody serum (ANAs).
Methods: The clinical data of expanded disability status scale (EDSS) score, duration of the first relieving phase and first year recurrence-positive rate and MRI features of 34 NMO patients at our hospital during the period of 2006-2011 were retrospectively reviewed and divided into two groups according to the outcome of antibodies test:ANAs positive group (n=14) and ANAs negative group (n=20).
Results: (1) In the ANAs-positive group, the EDSS score of first NMO attack was (2.8±1.1), first remission continued to (9±9) months and the first year recurrence-positive rate was 71.0%; in the ANAs-negative group, the EDSS score of first NMO attack was 2.3±0.8, first remission continued to (31±39) months and the first year recurrence-positive rate was 30.0%. The differences in the first attack EDSS score, duration of first remission and first recurrence rate between two groups were statistically significant (P<0.05). (2) Brain damage-positive rate in the ANAs-positive group on prompt MRI was 35.71% (5/14) and it was higher than that in ANAs-negative group (5/20). But no significant difference existed between two groups. The spinal cord lesions were predominantly located in cervical and thoracic spinal cords simultaneously in both groups (about 50% respectively). And, in the ANAs-positive group, the cervical lesions involved were much more common than the thoracic counterparts (6/14 vs 1/14). However, in the ANAs-negative group, thoracic segments were usually involved (6/20 vs 4/20).
Conclusion: With severe neurological deficits in the first clinical attack and a short remission, ANAs-positive NMO patients are more prone to relapse in the first year, brain damage and cervical cord injury.