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.

25 Hydroxyvitamin D concentrations in patients with optic neuritis as a clinically isolated syndrome and healthy controls

The onset of multiple sclerosis in the majority of the cases occurs as a clinically isolated syndrome [CIS]. We sought to assess serum levels of 25-hydroxyvitamin D [25-OHD] in CIS patients and healthy controls. In this cross-sectional study 40 patients [36 women and 4 men] with CIS manifesting as a single isolated optic neuritis and 40 Age- and sex-matched healthy controls [35 women and 5 men] were enrolled between late October 2010 and early March 2011. General vitamin D deficiency was defined as serum 25-OHD levels of lower than 20 ng/ml and was classified as mild [15 < 25-OHD <20 ng/ml], moderate [8 < 25-OHD <15 ng/ml], and severe [25- OHD <8 ng/ml]. We found no difference in the median interquartile range [IQR] between CIS patients and controls [17.95 [10.40- 29.13] vs. 17.00 [12.25-31.00]; P=0.57]. However, when stratified by the levels of deficiency, among CIS patients a significantly higher proportion had severe vitamin D deficiency in comparison to healthy controls [20% vs. 2.5%; P=0.034]. Nevertheless, the frequency of general [62.5% vs. 60%, P=0.82], mild [25% vs. 30%, P=0.80], and moderate [17.5% vs. 27.5%, P=0.42] vitamin D deficiency were not different between the two groups. Our findings do not indicate any significant difference of serum 25-OHD between CIS patients and healthy controls. However, in our series severe vitamin D deficiency was more frequent among CIS patients.

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