Highlights
- •AQP4-IgG-positive NMOSD patients had higher log sCK levels than the negative ones.
- •Male, serum AQP4-IgG and combined CTD were independent predictors of log sCK levels.
- •Muscle damage in NMOSD patients may be associated with AQP4-IgG.
Abstract
Background
Muscle damage has been found in patients with neuromyelitis optica spectrum disorder
(NMOSD), but whether this damage is related to aquaporin-4 immunoglobulin G antibodies
(AQP4-IgG) is uncertain. The aim of this study was to investigate the relationship
between AQP4-IgG and muscle damage.
Methods
From January 2009 to May 2019, we prospectively screened 1209 Chinese Han patients
with acute transverse myelitis (ATM). Ultimately, we included 203 ATM patients in
the cohort study and compared log serum creatine kinase (sCK) levels between positive
and negative AQP4-IgG statuses.
Results
Among all ATM patients, the mean log sCK levels of AQP4-IgG-positive patients were
higher than those of AQP4-IgG-negative patients (4.46 ± 0.10 vs. 4.16 ± 0.06, p < 0.001). In addition, among ATM patients diagnosed with NMOSD, the mean log sCK
levels of AQP4-IgG-positive patients were higher than those of AQP4-IgG-negative patients
(4.46 ± 0.10 vs. 4.05 ± 0.13, p = 0.025). The number of extremely high sCK values (sCK values > 300 IU/L) was significantly
higher in ATM patients positive for AQP4-IgG than in those negative for AQP4-IgG (p = 0.020). Furthermore, multivariable linear regression model analysis showed that
male sex (coefficient [95% CI] = 0.548 [0.286, 0.809], p < 0.001), serum AQP4-IgG (coefficient [95% CI] = 0.462 [0.237, 0.687], p < 0.001), and combined connective tissue disease (CTD) (coefficient [95% CI] = -0.686
[-1.145, -0.226], p = 0.004) were independent predictors of log sCK levels.
Conclusions
Our study suggests that muscle damage in NMOSD patients may be associated with AQP4-IgG.
Keywords
Abbreviations:
NMOSD (neuromyelitis optica spectrum disorder), ATM (acute transverse myelitis), IATM (idiopathic acute myelitis), AQP4-IgG (aquaporin-4 immunoglobulin G antibodies), sCK (serum creatine kinase), CTD (connective tissue disease), CNS (central nervous system), AQP4 (Aquaporin-4), BBB (blood-brain barrier), TMCWG (Transverse Myelitis Consortium Working Group), MOG-IgG (myelin oligodendrocyte glycoprotein immunoglobulin G antibody), OCBs (oligoclonal bands), MS (multiple sclerosis), MOG-EM (MOG-IgG-associated encephalomyelitis), SVMs (spinal vascular malformations), SCIs (spinal cord injuries), PNS (paraneoplastic syndrome), CBA (cell-based assay), MRI (magnetic resonance imaging), ANA (serum antinuclear antibody), anti-SSA (serum anti-Sjögren syndrome A), anti-SSB (serum anti-Sjögren syndrome B), eGFR (estimated glomerular filtration rate), CIs (confidence intervals), SLE (systemic lupus erythaematosus), SS (Sjögren syndrome)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 28, 2020
Accepted:
April 12,
2020
Received in revised form:
March 31,
2020
Received:
February 12,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
