Measurement of antibodies against aquaporin-4 is used to diagnose neuromyelitis optica (NMO) and related disorders, including recurrent transverse myelitis and recurrent optic neuritis. The measurement of aquaporin-4 antibodies is still used for the differential diagnosis of disorders of neuromyelitis optica spectrum from multiple sclerosis at the onset of the disease, as well as for monitoring the efficacy of treatment.
More information on optical neuromyelitis
Neuromyelitis optica (NMO), also known as Devic's disease, is a serious, relapsing, autoimmune, inflammatory, and demyelinating disease of the central nervous system that mainly affects the optic nerves and spinal cord. The disease is now seen as a spectrum of autoimmune diseases (called neuromyelitis optica spectrum disorders or NMOSD), where autoantibodies target the astrocyte water channel molecule called aquaporin-4 (AQP4). Brain damage occurs in 60% of NMOSD patients and approximately 10% have symptoms similar to multiple sclerosis. Children tend to have greater brain involvement than adults, and brain damage is more symptomatic than in adult patients.
The clinical course of the disease is characterized by relapses of optic neuritis or transverse myelitis or both. Many patients with NMOSD are incorrectly diagnosed as having multiple sclerosis. Both the prognosis and the optimal treatments for the two diseases vary. NMOSD is generally worse than multiple sclerosis, with frequent and early relapses. NMOSD outbreaks are often severe, resulting in rapid disability accumulation (blindness and paraplegia). The most effective treatments, combined with quicker and more accurate diagnoses, lead to improved results.
Treatments for NMOSD include corticosteroids and plasmapheresis during acute attacks and mycophenolate mofetil, azathioprine, and rituximab to prevent relapses. Interferon-beta, a treatment used in multiple sclerosis, worsens NMOSD. Therefore, early diagnosis and initiation of appropriate immunosuppressive therapy are important for optimizing clinical outcomes and preventing relapses.
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.