Skip to main content

Advertisement

SpringerLink
Log in

Neuromyelitis optica spectrum disorders associated with other autoimmune diseases

  • Review Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Neuromyelitis optica (NMO) is an inflammatory demyelinating autoimmune disease with severe, tremendously incapacitating, consequences in the patient’s health and wellbeing. Until 2004, NMO was considered a restricted type of multiple sclerosis but in the same year an auto-antibody reacting against aquaporin-4 (NMO-IgG) was found to be related with NMO and it was considered the main etiologic agent of this disease. Its detection is very sensitive and specific allowing an early diagnosis and a better treatment and prognosis. With this tool, a spectrum of diseases including other autoimmune diseases was found to have NMO-IgG antibodies and a new classification named NMO spectrum disorders was created. In this review, we sum up the developments in this field associated with other autoimmune diseases. We approach the latest discoveries in the diagnosis like the new biomarkers that will possibly be used in the close future or the developments in the neuroimaging techniques. We reviewed the literature and synthesized case reports of NMO patients with concurrent autoimmune diseases and the information from useful larger studies. Finally, we summarize the commonly used treatments in NMO and we try to specify the best treatment for NMO with simultaneous autoimmune disease. This review updates the information about this issue and raises the awareness of rheumatologists for these severe diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sellner J, Boggild M, Clanet M, Hintzen RQ, Illes Z, Montalban X, Du Pasquier RA, Polman CH, Sorensen PS, Hemmer B (2010) EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol 17(8):1019–1032. doi:10.1111/j.1468-1331.2010.03066.x

    Article  CAS  PubMed  Google Scholar 

  2. Fazio R, Radaelli M, Furlan R (2011) Neuromyelitis optica: concepts in evolution. J Neuroimmunol 231(1–2):100–104. doi:10.1016/j.jneuroim.2010.10.012

    Article  CAS  PubMed  Google Scholar 

  3. Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, Nakashima I, Weinshenker BG (2004) A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364(9451):2106–2112. doi:10.1016/S0140-6736(04)17551-X

    Article  CAS  PubMed  Google Scholar 

  4. Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR (2005) IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 202(4):473–477. doi:10.1084/jem.20050304

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Kim W, Kim SH, Huh SY, Kim HJ (2012) Brain abnormalities in neuromyelitis optica spectrum disorder. Mult Scler Int 2012:735486. doi:10.1155/2012/735486

    PubMed Central  PubMed  Google Scholar 

  6. Weinshenker BG, Wingerchuk DM, Pittock SJ, Lucchinetti CF, Lennon VA (2006) NMO-IgG: a specific biomarker for neuromyelitis optica. Dis Markers 22(4):197–206

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Pittock SJ, Lennon VA, de Seze J, Vermersch P, Homburger HA, Wingerchuk DM, Lucchinetti CF, Zephir H, Moder K, Weinshenker BG (2008) Neuromyelitis optica and non organ-specific autoimmunity. Arch Neurol 65(1):78–83. doi:10.1001/archneurol.2007.17

    Article  PubMed  Google Scholar 

  8. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O’Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302. doi:10.1002/ana.22366

    Article  PubMed Central  PubMed  Google Scholar 

  9. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG (2007) The spectrum of neuromyelitis optica. Lancet Neurol 6(9):805–815. doi:10.1016/S1474-4422(07)70216-8

    Article  CAS  PubMed  Google Scholar 

  10. Matà S, Lolli F (2011) Neuromyelitis optica: an update. J Neurol Sci 303(1–2):13–21. doi:10.1016/j.jns.2011.01.002

    Article  PubMed  Google Scholar 

  11. Bizzoco E, Lolli F, Repice AM, Hakiki B, Falcini M, Barilaro A, Taiuti R, Siracusa G, Amato MP, Biagioli T, Lori S, Moretti M, Vinattieri A, Nencini P, Massacesi L, Mata S (2009) Prevalence of neuromyelitis optica spectrum disorder and phenotype distribution. J Neurol 256(11):1891–1898. doi:10.1007/s00415-009-5171-x

    Article  PubMed  Google Scholar 

  12. Jarius S, Jacobi C, de Seze J, Zephir H, Paul F, Franciotta D, Rommer P, Mader S, Kleiter I, Reindl M, Akman-Demir G, Seifert-Held T, Kristoferitsch W, Melms A, Wandinger KP, Wildemann B (2011) Frequency and syndrome specificity of antibodies to aquaporin-4 in neurological patients with rheumatic disorders. Mult Scler (Houndmills, Basingstoke, England) 17(9):1067–1073. doi:10.1177/1352458511403958

    Article  CAS  Google Scholar 

  13. Kolfenbach JR, Horner BJ, Ferucci ED, West SG (2011) Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis. Arthritis Care Res 63(8):1203–1208. doi:10.1002/acr.20486

    Article  Google Scholar 

  14. Wingerchuk DM, Weinshenker BG (2012) The emerging relationship between neuromyelitis optica and systemic rheumatologic autoimmune disease. Mult Scler (Houndmills, Basingstoke, England) 18(1):5–10. doi:10.1177/1352458511431077

    Article  CAS  Google Scholar 

  15. McKeon A, Lennon VA, Jacob A, Matiello M, Lucchinetti CF, Kale N, Chan KH, Weinshenker BG, Apiwattinakul M, Wingerchuk DM, Pittock SJ (2009) Coexistence of myasthenia gravis and serological markers of neurological autoimmunity in neuromyelitis optica. Muscle Nerve 39(1):87–90. doi:10.1002/mus.21197

    Article  PubMed  Google Scholar 

  16. Uzawa A, Mori M, Iwai Y, Kobayashi M, Hayakawa S, Kawaguchi N, Kuwabara S (2009) Association of anti-aquaporin-4 antibody-positive neuromyelitis optica with myasthenia gravis. J Neurol Sci 287(1–2):105–107. doi:10.1016/j.jns.2009.08.040

    Article  CAS  PubMed  Google Scholar 

  17. Jarius S, Paul F, Franciotta D, de Seze J, Munch C, Salvetti M, Ruprecht K, Liebetrau M, Wandinger KP, Akman-Demir G, Melms A, Kristoferitsch W, Wildemann B (2012) Neuromyelitis optica spectrum disorders in patients with myasthenia gravis: ten new aquaporin-4 antibody positive cases and a review of the literature. Mult Scler (Houndmills, Basingstoke, England) 18(8):1135–1143. doi:10.1177/1352458511431728

    Article  CAS  Google Scholar 

  18. Leite MI, Coutinho E, Lana-Peixoto M, Apostolos S, Waters P, Sato D, Melamud L, Marta M, Graham A, Spillane J, Villa AM, Callegaro D, Santos E, da Silva AM, Jarius S, Howard R, Nakashima I, Giovannoni G, Buckley C, Hilton-Jones D, Vincent A, Palace J (2012) Myasthenia gravis and neuromyelitis optica spectrum disorder: a multicenter study of 16 patients. Neurology 78(20):1601–1607. doi:10.1212/WNL.0b013e31825644ff

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Kay CS, Scola RH, Lorenzoni PJ, Jarius S, Arruda WO, Werneck LC (2008) NMO-IgG positive neuromyelitis optica in a patient with myasthenia gravis but no thymectomy. J Neurol Sci 275(1–2):148–150. doi:10.1016/j.jns.2008.06.038

    Article  PubMed  Google Scholar 

  20. Chan KH, Kwan JS, Ho PW, Ho SL, Chui WH, Chu AC, Ho JW, Zhang WY, Kung MH (2010) Aquaporin-4 water channel expression by thymoma of patients with and without myasthenia gravis. J Neuroimmunol 227(1–2):178–184. doi:10.1016/j.jneuroim.2010.07.016

    Article  CAS  PubMed  Google Scholar 

  21. Klein R, Marx A, Ströbel P, Schalke B, Nix W, Willcox N (2013) Autoimmune associations and autoantibody screening show focused recognition in patient subgroups with generalized myasthenia gravis. Hum Immunol 74(9):1184–1193. doi:10.1016/j.humimm.2013.06.020

    Article  CAS  PubMed  Google Scholar 

  22. Vincent A, Waters P, Leite MI, Jacobson L, Koneczny I, Cossins J, Beeson D (2012) Antibodies identified by cell-based assays in myasthenia gravis and associated diseases. Ann N Y Acad Sci 1274:92–98. doi:10.1111/j.1749-6632.2012.06789.x

    Article  CAS  PubMed  Google Scholar 

  23. Javed A, Balabanov R, Arnason BG, Kelly TJ, Sweiss NJ, Pytel P, Walsh R, Blair EA, Stemer A, Lazzaro M, Reder AT (2008) Minor salivary gland inflammation in Devic’s disease and longitudinally extensive myelitis. Mult Scler (Houndmills, Basingstoke, England) 14(6):809–814. doi:10.1177/1352458508088941

    Article  CAS  Google Scholar 

  24. Kim SM, Waters P, Vincent A, Kim SY, Kim HJ, Hong YH, Park KS, Min JH, Sung JJ, Lee KW (2009) Sjogren’s syndrome myelopathy: spinal cord involvement in Sjogren’s syndrome might be a manifestation of neuromyelitis optica. Mult Scler (Houndmills, Basingstoke, England) 15(9):1062–1068. doi:10.1177/1352458509106636

    Article  CAS  Google Scholar 

  25. Min JH, Kim HJ, Kim BJ, Lee KW, Sunwoo IN, Kim SM, Kim BJ, Kim SH, Park MS, Waters P, Vincent A, Sung JJ, Lee KH (2009) Brain abnormalities in Sjogren syndrome with recurrent CNS manifestations: association with neuromyelitis optica. Mult Scler (Houndmills, Basingstoke, England) 15(9):1069–1076. doi:10.1177/1352458509106228

    Article  CAS  Google Scholar 

  26. Gokcay F, Celebisoy N, Gokcay A, Kabasakal Y, Oder G (2007) Primary Sjogrens syndrome presenting as neuromyelitis optica. Pediatr Neurol 36(1):58–60. doi:10.1016/j.pediatrneurol.2006.07.008

    Article  PubMed  Google Scholar 

  27. Kahlenberg JM (2011) Neuromyelitis optica spectrum disorder as an initial presentation of primary Sjogren’s syndrome. Semin Arthritis Rheum 40(4):343–348. doi:10.1016/j.semarthrit.2010.05.005

    Article  PubMed  Google Scholar 

  28. Tan P, Yu WY, Umapathi T, Lim SA (2012) Severe optic neuritis in a patient with combined neuromyelitis optica spectrum disease and primary Sjogren’s syndrome: a case report. J Med Case Rep 6(1):401. doi:10.1186/1752-1947-6-401

    Article  PubMed Central  PubMed  Google Scholar 

  29. Min JH, Kim SH, Park MS, Kim BJ, Lee KH (2010) Brain MRI lesions characteristic of neuromyelitis optica and positive anti-aquaporin 4-antibody may predict longitudinal extensive myelitis and optic neuritis in Sjogren’s syndrome. Mult Scler (Houndmills, Basingstoke, England) 16(6):762–764. doi:10.1177/1352458510361740

    Article  Google Scholar 

  30. Koga S, Ikeda K, Nakagomi D, Mori M, Kuwabara S, Nakajima H (2011) A patient with neuromyelitis optica with positive anti-Ro (SS-A) antibody presenting with intractable hiccup and nausea. Mod Rheumatol/Jpn Rheum Assoc 21(5):561–562. doi:10.1007/s10165-011-0438-3

    Article  Google Scholar 

  31. Katsumata Y, Kawachi I, Kawaguchi Y, Gono T, Ichida H, Hara M, Yamanaka H (2012) Semiquantitative measurement of aquaporin-4 antibodies as a possible surrogate marker of neuromyelitis optica spectrum disorders with systemic autoimmune diseases. Mod Rheumatol/Jpn Rheum Assoc 22(5):676–684. doi:10.1007/s10165-011-0572-y

    Article  CAS  Google Scholar 

  32. Birnbaum J, Kerr D (2008) Optic neuritis and recurrent myelitis in a woman with systemic lupus erythematosus. Nat Clin Pract Rheumatol 4(7):381–386. doi:10.1038/ncprheum0818

    PubMed  Google Scholar 

  33. Mehta LR, Samuelsson MK, Kleiner AK, Goodman AD, Anolik JH, Looney RJ, Schwid SR (2008) Neuromyelitis optica spectrum disorder in a patient with systemic lupus erythematosus and anti-phospholipid antibody syndrome. Mult Scler (Houndmills, Basingstoke, England) 14(3):425–427. doi:10.1177/1352458507084107

    Article  Google Scholar 

  34. Polgár A, Rózsa C, Müller V, Matolcsi J, Poór G, Kiss EV (2011) Devic’s syndrome and SLE: challenges in diagnosis and therapeutic possibilities based on two overlapping cases. Autoimmun Rev 10(3):171–174. doi:10.1016/j.autrev.2010.09.021

    Article  PubMed  Google Scholar 

  35. Arul Selvan VL (2013) A case of neuromyelitis optica as a presenting manifestation of systemic lupus erythematosus. Apollo Med 10(3):226–229. doi:10.1016/j.apme.2013.08.005

    Article  Google Scholar 

  36. Mottaghi P, Ashtari F, Karimzadeh H, Seidbonakdar Z, Karimifar M, Salesi M (2009) Devic’s syndrome concomitant with nephritis in a young woman. Clin Rheumatol 28(10):1239–1240. doi:10.1007/s10067-009-1232-x

    Article  PubMed  Google Scholar 

  37. Franciotta D, Zardini E, Caporali R, Piccolo L, Alberici E, Romani A, Bergamaschi R, Marchioni E, Ceroni M, Piccolo G (2011) Systemic sclerosis in aquaporin-4 antibody-positive longitudinally extensive transverse myelitis. J Neurol Sci 303(1–2):139–141. doi:10.1016/j.jns.2011.01.011

    Article  CAS  PubMed  Google Scholar 

  38. Sawaya R, Radwan W (2013) Sarcoidosis associated with neuromyelitis optica. J Clin Neurosc 20(8):1156–1158. doi:10.1016/j.jocn.2012.09.030

    Article  Google Scholar 

  39. Jacob A, McKeon A, Nakashima I, Sato DK, Elsone L, Fujihara K, de Seze J (2013) Current concept of neuromyelitis optica (NMO) and NMO spectrum disorders. J Neurol Neurosurg Psychiatry 84(8):922–930. doi:10.1136/jnnp-2012-302310

    Article  PubMed  Google Scholar 

  40. González C, González-Buitrago JM, Izquierdo G (2013) Aquaporins, anti-aquaporin-4 autoantibodies and neuromyelitis optica. Clin Chim Acta 415(0):350–360. doi:10.1016/j.cca.2012.04.027

    Article  PubMed  Google Scholar 

  41. Misu T, Hoftberger R, Fujihara K, Wimmer I, Takai Y, Nishiyama S, Nakashima I, Konno H, Bradl M, Garzuly F, Itoyama Y, Aoki M, Lassmann H (2013) Presence of six different lesion types suggests diverse mechanisms of tissue injury in neuromyelitis optica. Acta Neuropathol 125(6):815–827. doi:10.1007/s00401-013-1116-7

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Vincent T, Saikali P, Cayrol R, Roth AD, Bar-Or A, Prat A, Antel JP (2008) Functional consequences of neuromyelitis optica-IgG astrocyte interactions on blood–brain barrier permeability and granulocyte recruitment. J Immunol (Baltimore, Md : 1950) 181(8):5730–5737

    Article  CAS  Google Scholar 

  43. Waters P, Vincent A (2008) Detection of anti-aquaporin-4 antibodies in neuromyelitis optica: current status of the assays. Int MS J/MS Forum 15(3):99–105

    CAS  Google Scholar 

  44. Kalluri SR, Illes Z, Srivastava R, Cree B, Menge T, Bennett JL, Berthele A, Hemmer B (2010) Quantification and functional characterization of antibodies to native aquaporin 4 in neuromyelitis optica. Arch Neurol 67(10):1201–1208. doi:10.1001/archneurol.2010.269

    Article  PubMed  Google Scholar 

  45. Waters PJ, McKeon A, Leite MI, Rajasekharan S, Lennon VA, Villalobos A, Palace J, Mandrekar JN, Vincent A, Bar-Or A, Pittock SJ (2012) Serologic diagnosis of NMO: a multicenter comparison of aquaporin-4-IgG assays. Neurology 78(9):665–671. doi:10.1212/WNL.0b013e318248dec1 (discussion 669)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Oh J, Levy M (2012) Neuromyelitis optica: an antibody-mediated disorder of the central nervous system. Neurol Res Int 2012:460825. doi:10.1155/2012/460825

    Article  PubMed Central  PubMed  Google Scholar 

  47. Dellavance A, Alvarenga RR, Rodrigues SH, Kok F, de Souza AWS, Andrade LEC (2012) Anti-aquaporin-4 antibodies in the context of assorted immune-mediated diseases. Eur J Neurol 19(2):248–252. doi:10.1111/j.1468-1331.2011.03479.x

    Article  CAS  PubMed  Google Scholar 

  48. Jarius S, Paul F, Franciotta D, Ruprecht K, Ringelstein M, Bergamaschi R, Rommer P, Kleiter I, Stich O, Reuss R, Rauer S, Zettl UK, Wandinger KP, Melms A, Aktas O, Kristoferitsch W, Wildemann B (2011) Cerebrospinal fluid findings in aquaporin-4 antibody positive neuromyelitis optica: results from 211 lumbar punctures. J Neurol Sci 306(1–2):82–90. doi:10.1016/j.jns.2011.03.038

    Article  CAS  PubMed  Google Scholar 

  49. Jarius S, Franciotta D, Paul F, Ruprecht K, Bergamaschi R, Rommer PS, Reuss R, Probst C, Kristoferitsch W, Wandinger KP, Wildemann B (2010) Cerebrospinal fluid antibodies to aquaporin-4 in neuromyelitis optica and related disorders: frequency, origin, and diagnostic relevance. J Neuroinflammation 7:52. doi:10.1186/1742-2094-7-52

    Article  PubMed Central  PubMed  Google Scholar 

  50. Long Y, Qiu W, Lu Z, Bao J, Wu A, Wang Y, Wang H, Hu X (2012) Aquaporin 4 antibodies in the cerebrospinal fluid are helpful in diagnosing Chinese patients with neuromyelitis optica. Neuroimmunomodulation 19(2):96–102. doi:10.1159/000330240

    Article  CAS  PubMed  Google Scholar 

  51. Mader S, Gredler V, Schanda K, Rostasy K, Dujmovic I, Pfaller K, Lutterotti A, Jarius S, Di Pauli F, Kuenz B, Ehling R, Hegen H, Deisenhammer F, Aboul-Enein F, Storch MK, Koson P, Drulovic J, Kristoferitsch W, Berger T, Reindl M (2011) Complement activating antibodies to myelin oligodendrocyte glycoprotein in neuromyelitis optica and related disorders. J Neuroinflammation 8:184. doi:10.1186/1742-2094-8-184

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  52. Uzawa A, Mori M, Sawai S, Masuda S, Muto M, Uchida T, Ito S, Nomura F, Kuwabara S (2013) Cerebrospinal fluid interleukin-6 and glial fibrillary acidic protein levels are increased during initial neuromyelitis optica attacks. Clin Chim Acta 421:181–183. doi:10.1016/j.cca.2013.03.020

    Article  CAS  PubMed  Google Scholar 

  53. Storoni M, Petzold A, Plant GT (2011) The use of serum glial fibrillary acidic protein measurements in the diagnosis of neuromyelitis optica spectrum optic neuritis. PLoS One 6(8):e23489. doi:10.1371/journal.pone.0023489

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  54. Wang KC, Tsai CP, Lee CL, Chen SY, Chin LT, Chen SJ (2012) Elevated plasma high-mobility group box 1 protein is a potential marker for neuromyelitis optica. Neuroscience 226:510–516. doi:10.1016/j.neuroscience.2012.08.041

    Article  CAS  PubMed  Google Scholar 

  55. Tzartos JS, Stergiou C, Kilidireas K, Zisimopoulou P, Thomaidis T, Tzartos SJ (2013) Anti-aquaporin-1 autoantibodies in patients with neuromyelitis optica spectrum disorders. PLoS One 8(9):e74773. doi:10.1371/journal.pone.0074773

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  56. Miller DH, Weinshenker BG, Filippi M, Banwell BL, Cohen JA, Freedman MS, Galetta SL, Hutchinson M, Johnson RT, Kappos L, Kira J, Lublin FD, McFarland HF, Montalban X, Panitch H, Richert JR, Reingold SC, Polman CH (2008) Differential diagnosis of suspected multiple sclerosis: a consensus approach. Mult Scler (Houndmills, Basingstoke, England) 14(9):1157–1174. doi:10.1177/1352458508096878

    Article  CAS  Google Scholar 

  57. Kim W, Kim SH, Lee SH, Li XF, Kim HJ (2011) Brain abnormalities as an initial manifestation of neuromyelitis optica spectrum disorder. Mult Scler (Houndmills, Basingstoke, England) 17(9):1107–1112. doi:10.1177/1352458511404917

    Article  Google Scholar 

  58. Min JH, Waters P, Vincent A, Kang ES, Lee S, Lee DK, Lee KH, Kim BJ (2013) Symptomatic brain involvement as the initial manifestation of neuromyelitis optica. J Clin Neurosc 20(7):938–942. doi:10.1016/j.jocn.2012.08.007

    Article  Google Scholar 

  59. Kuker W (2007) Imaging of cerebral vasculitis. Int J Stroke 2(3):184–190. doi:10.1111/j.1747-4949.2007.00134.x

    Article  PubMed  Google Scholar 

  60. Eckstein C, Saidha S, Levy M (2012) A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis. J Neurol 259(5):801–816. doi:10.1007/s00415-011-6240-5

    Article  PubMed  Google Scholar 

  61. Kimbrough DJ, Fujihara K, Jacob A, Lana-Peixoto MA, Isabel Leite M, Levy M, Marignier R, Nakashima I, Palace J, de Seze J, Stuve O, Tenembaum SN, Traboulsee A, Waubant E, Weinshenker BG, Wingerchuk DM (2012) Treatment of neuromyelitis optica: review and recommendations. Mult Scler Relat Disord 1(4):180–187. doi:10.1016/j.msard.2012.06.002

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  62. Bonnan M, Valentino R, Olindo S, Mehdaoui H, Smadja D, Cabre P (2009) Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder. Mult Scler (Houndmills, Basingstoke, England) 15(4):487–492. doi:10.1177/1352458508100837

    Article  CAS  Google Scholar 

  63. Lim YM, Pyun SY, Kang BH, Kim J, Kim KK (2013) Factors associated with the effectiveness of plasma exchange for the treatment of NMO-IgG-positive neuromyelitis optica spectrum disorders. Mult Scler (Houndmills, Basingstoke, England) 19(9):1216–1218. doi:10.1177/1352458512471875

    Article  Google Scholar 

  64. Yaguchi H, Sakushima K, Takahashi I, Nishimura H, Yashima-Yamada M, Nakamura M, Tsuzaka K, Maruo Y, Takahashi T, Yabe I, Sasaki H (2013) Efficacy of intravenous cyclophosphamide therapy for neuromyelitis optica spectrum disorder. Intern Med (Tokyo, Japan) 52(9):969–972

    Article  CAS  Google Scholar 

  65. Jacob A, Matiello M, Weinshenker BG et al (2009) Treatment of neuromyelitis optica with mycophenolate mofetil: retrospective analysis of 24 patients. Arch Neurol 66(9):1128–1133. doi:10.1001/archneurol.2009.175

    Article  PubMed  Google Scholar 

  66. Kitley J, Elsone L, George J, Waters P, Woodhall M, Vincent A, Jacob A, Leite MI, Palace J (2013) Methotrexate is an alternative to azathioprine in neuromyelitis optica spectrum disorders with aquaporin-4 antibodies. J Neurol Neurosurg Psychiatry 84(8):918–921. doi:10.1136/jnnp-2012-304774

    Article  PubMed  Google Scholar 

  67. Bedi GS, Brown AD, Delgado SR, Usmani N, Lam BL, Sheremata WA (2011) Impact of rituximab on relapse rate and disability in neuromyelitis optica. Mult Scler (Houndmills, Basingstoke, England) 17(10):1225–1230. doi:10.1177/1352458511404586

    Article  CAS  Google Scholar 

  68. Ip VH, Lau AY, Au LW, Fan FS, Chan AY, Mok VC, Wong KS (2013) Rituximab reduces attacks in Chinese patients with neuromyelitis optica spectrum disorders. J Neurol Sci 324(1–2):38–39. doi:10.1016/j.jns.2012.09.024

    Article  CAS  PubMed  Google Scholar 

  69. Danes I, Agusti A, Vallano A, Martinez J, Alerany C, Ferrer A, Lopez A, Cortes-Hernandez J, Bosch JA (2013) Available evidence and outcome of off-label use of rituximab in clinical practice. Eur J Clin Pharmacol 69(9):1689–1699. doi:10.1007/s00228-013-1518-4

    Article  CAS  PubMed  Google Scholar 

  70. Pittock SJ, Lennon VA, McKeon A, Mandrekar J, Weinshenker BG, Lucchinetti CF, O’Toole O, Wingerchuk DM (2013) Eculizumab in AQP4-IgG-positive relapsing neuromyelitis optica spectrum disorders: an open-label pilot study. Lancet Neurol 12(6):554–562. doi:10.1016/s1474-4422(13)70076-0

    Article  CAS  PubMed  Google Scholar 

  71. Gurcan HM, Keskin DB, Stern JN, Nitzberg MA, Shekhani H, Ahmed AR (2009) A review of the current use of rituximab in autoimmune diseases. Int Immunopharmacol 9(1):10–25. doi:10.1016/j.intimp.2008.10.004

    Article  PubMed  Google Scholar 

  72. Kim SH, Kim W, Huh SY, Lee KY, Jung IJ, Kim HJ (2013) Clinical efficacy of plasmapheresis in patients with neuromyelitis optica spectrum disorder and effects on circulating anti-aquaporin-4 antibody levels. J Clin Neurol (Seoul, Korea) 9(1):36–42. doi:10.3988/jcn.2013.9.1.36

    Article  Google Scholar 

  73. Elsone L, Panicker J, Mutch K, Boggild M, Appleton R, Jacob A (2013) Role of intravenous immunoglobulin in the treatment of acute relapses of neuromyelitis optica: experience in 10 patients. Mult Scler. doi:10.1177/1352458513495938

    Google Scholar 

  74. Guimarães J, Sá M (2007) Devic disease with abnormal brain magnetic resonance image findings: the first portuguese case. Arch Neurol 64(2):290–291. doi:10.1001/archneur.64.2.290

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Neurology Department, Hospital de São João, Faculty of Medicine, University of Porto, Porto, Portugal

    Eduardo Freitas & Joana Guimarães

  2. Neurology and Neurosurgery Unit of Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Porto, Porto, Portugal

    Joana Guimarães

  3. Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal

    Joana Guimarães

Authors
  1. Eduardo Freitas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joana Guimarães
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eduardo Freitas.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Freitas, E., Guimarães, J. Neuromyelitis optica spectrum disorders associated with other autoimmune diseases. Rheumatol Int 35, 243–253 (2015). https://doi.org/10.1007/s00296-014-3066-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-014-3066-3

Keywords

Search

Navigation