MOG-IgG associated optic neuritis is not multiple sclerosis.

Autoantibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported in patients with inflammatory central nervous system disorders including isolated optic neuritis (ON). We compared our MOG-IgG ON patients with multiple sclerosis (MS) patients presenting with ON. METHODS AND RESULTS: Among the total of 38 patients with optic neuropathies, six patients with isolated ON were MOG-IgG positive and eight patients with ON fulfilled the diagnostic criteria for MS. All MS patients were negative for MOG-IgG using a cell-based assay. When compared with the MS group, the MOG-IgG patients were older (mean 47 years), more frequently male (ratio 2:1) and had a higher frequency of bilateral and/or recurrent ON. The brain magnetic resonance imaging of all MOG-IgG positive patients was normal or had only unspecific white matter T2 lesions. CONCLUSION: These findings suggest that MOG-IgG is a biomarker of an inflammatory demyelinating CNS disease distinct from MS.

MOG-IgG associated optic neuritis is not multiple sclerosis / Neurite óptica associada ao MOG-IgG não é esclerose múltipla

ABSTRACT Autoantibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported in patients with inflammatory central nervous system disorders including isolated optic neuritis (ON). We compared our MOG-IgG ON patients with multiple sclerosis (MS) patients presenting with ON. Methods and results: Among the total of 38 patients with optic neuropathies, six patients with isolated ON were MOG-IgG positive and eight patients with ON fulfilled the diagnostic criteria for MS. All MS patients were negative for MOG-IgG using a cell-based assay. When compared with the MS group, the MOG-IgG patients were older (mean 47 years), more frequently male (ratio 2:1) and had a higher frequency of bilateral and/or recurrent ON. The brain magnetic resonance imaging of all MOG-IgG positive patients was normal or had only unspecific white matter T2 lesions. Conclusion: These findings suggest that MOG-IgG is a biomarker of an inflammatory demyelinating CNS disease distinct from MS.

RESUMO Autoanticorpos contra a glicoproteína da mielina do oligodendrócito (MOG-IgG) têm sido descritos em pacientes com neurite óptica (NO) isolada, entre outras doenças inflamatórias do sistema nervoso central. Comparamos os nossos pacientes com NO MOG-IgG positivos com pacientes com NO associada a esclerose múltipla (EM). Materias e métodos: De um total de 38 pacientes com neuropatia óptica, seis foram MOG-IgG positivos e oito preencheram critérios diagnósticos para EM. Todos os pacientes com EM foram negativos para MOG-IgG (ensaio baseado em células). Quando comparados ao grupo com EM, os pacientes MOG-IgG positivos apresentam idade mais avançada (mediana de 47 anos) e tiveram uma frequência maior de NO bilateral e/ou recorrente. Houve predomínio masculino (relação 2:1). A ressonância magnética de encéfalo de todos os pacientes MOG-IgG positivos foi normal ou demonstrou apenas lesões inespecíficas em T2. Conclusão: Nossos achados sugerem que o MOG-IgG é um biomarcador de doença desmielinizante diferente da EM.

Neurologic dengue manifestations associated with intrathecal specific immune response.

BACKGROUND: Dengue infection is caused by a flavivirus, with 4 virus serotypes (types 1 to 4). The serotypes 2 and 3 represent the principal agents related to nervous system involvement. Neurologic involvement occurs in 4%-5% of dengue infection cases. The major mechanisms of the disease may be related to direct viral infection or postinfectious autoimmune process. The detection of intrathecal synthesis of specific antibodies has been used to support neurologic diagnosis as a proof of local reaction. It may be quantitatively calculated by the specific antibody index. OBJECTIVES: To determine if patients with neurologic manifestations associated with dengue produce specific antibodies in the CNS and to determine the antibodies' clinical and pathophysiologic relevance. METHODS: CSF and serum were evaluated for dengue immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies by ELISA and for intrathecal synthesis of IgG antibodies to the dengue virus. Subjects included 10 patients IgM seropositive for dengue virus diagnosed with myelitis, encephalitis, optic neuromyelitis, or Guillain-Barré syndrome. RESULTS: All patients had IgG and IgM antibodies to dengue virus in their sera; 7 were IgM positive and 9 were IgG positive for dengue virus in CSF. Only the 3 patients with myelitis had intrathecal synthesis of specific IgG antibodies. CONCLUSIONS: Intrathecal synthesis of antibodies to dengue virus occurs in the CNS. It may be used as a marker of myelitis associated with dengue, and it seems to be related to the pathogenesis of spinal cord disease due to direct viral invasion.

Optic neuritis progressing to multiple sclerosis.

We report a partially retrospective and longitudinal study of patients with optic neuritis (ON) that developed multiple sclerosis (MS). We assessed clinical features or factors that might differentiate these patients from those with ON that did not develop MS. Of the cases followed, 110 (67%) were found to have an idiopathic origin of the disease; whereas 55 (33%) were found to develop it secondary to another disease. Of the 110 idiopathic cases, 13 (12%), developed MS over an average of 2 years. The results of these patients in the laboratory analyses of blood and CSF as well as the results of the MRI and evoked potential studies, were significantly different from the ON patients without MS. We conclude that the percentage of patients with ON in our sample that developed MS is similar to that found in Japan and is relatively low in comparison to other reports.

Local IgG synthesis in three pediatric patients with Cuban epidemic neuropathy

Three pediatric patients with Cuban epidemic neuropathy were studied. Cerebrospinal fluid and sera were simultaneously obtained. Albumin and IgG were quantified by immunodifusion. Albumin quotient and local synthesis of IgG were calculated by Reibert/Felgenhauer formula. A patient with optic neuritis had a dysfunction of the blood-cerebrospinal fluid barrier. All the group had local synthesis of IgG.

Neuropatia epidemica cubana. Parte III. Anticuerpos neutralizantes a cepas aisladas y otros Enterovirus en pacientes y personas sanas / Cuban epidemic neuropathy. Part III. Neutralizing antibodies to isolated strains and to other enteroviruses in patients and healthy subjects

Se realizaron determinaciones de anticuerpos neutralizantes en sueros de pacientes con neuropatia epidemica y de grupos de personas aparentemente sanas, a la cepa 47/93 IPK (CA9) y la 590 productora de efecto citopatico ligero (ECP-L), asi como a las cepas de referencia de CA9 y CB1-6, por la tecnica de microneutralizacion. Los enfermos y sus contactos mostraron porcentajes significativamente superiores de anticuerpos neutralizantes a la cepa 47-93 que el grupo considerado control y los residentes en municipios de baja tasa de la enfermedad. Esta diferencia tambien se comprobo en los titulos promedio geometrico (TPG) con las cepas de referencia de CA9 y CB2-4. Se comprobo un incremento de la circulacion de la cepa 47/93 en la poblacion infantil desde 1981 a 1993. Los enfermos mostraron porcentajes y TPG significativamente menores de anticuerpos neutralizantes a la cepa 590 que el grupo control, a pesar de que en 25/28 se habian aislados agentes con ECP-L. Se plantea la posibilidad de 2 mecanismos de neutralizacion y se formula una hipotesis sobre el mecanismo por el cual estos virus puedan participar en la fisiopatologia de la enfermedad

Comparacion de los resultados obtenidos en la serologia de IgM y la neutralizacion anti-Coxsackie A9 (cepa 47) en casos de neuropatia epidemica y sus contactos / Comparison of the results obtained in IgM serology and the neutralization of anti-Coxsackie A9 (strain 47) in cases presenting with epidemic with epidemic neuropathy and their contacts

Se estudio un total de 213 monosueros de pacientes con el diagnostico de neuropatia epidemica y sus contactos, por las tecnicas de inmunofluorescencia indirecta y neutralizacion, con el fin de demostrar la presencia de anticuerpos IgM y neutralizantes en los sueros frente a la cepa 47 IPK/93 identificada como Coxsackie A9. La edad promedio de estos pacientes oscilo entre 20 y 50 anos y la positividad a ambas tecnicas no predomino. No hubo diferencia significativa en los resultados obtenidos entre pacientes y contactos en las tecnicas empleadas