Anti-nuclear antibodies in patients with suspicion of neuromyelitis optica spectrum disorder: Frequency and significance.

BACKGROUD &

OBJECTIVES

Neuromyelitis Optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease involving optic nerves and spinal cord. The association of NMOSD with anti-nuclear antibodies and autoimmune disorders has been reported. This study was conducted to determine frequency of anti-nuclear antibodies (ANA) in patients with NMOSD and to observe for the development of symptoms related to autoimmune disorders on follow up.

METHODOLOGY: After approval from Institutional Review Board, this cross-sectional study was conducted at Immunology Department, Shifa International Hospital, Islamabad, Pakistan and after informed verbal consent from patients, serum samples were tested by indirect immunofluorescence for anti-aquaporin four antibodies (AQP-4) and ANA. Clinical data of patient was collected via a structured questionnaire. Follow-up of 6-12 months was conducted in patients who were positive for ANA.

RESULTS

Total 248 patients were included in this study of which 32 were positive for AQP4- Antibodies (mean age 32.4 ± 14.1 years), out of which ANA was positive in 17 (53%) patients whereas in AQP-4 negative group, ANA was positive in 70 (32%) patients. At one year follow-up, in AQP-4 and ANA positive group, two patients were diagnosed with autoimmune thyroid disorders and one patient was diagnosed with Systemic Lupus Erythematosus.

CONCLUSION

In this study, we concluded that ANA were observed more frequently with AQP-4 antibody positivity. Considering this, detection of ANA in AQP-4 antibody positive patients may help in establishing early diagnosis of an accompanying autoimmune disease leading to early diagnosis and an overall favorable outcome in patients.