Clinical relevance of anti-Aquaporin antibody (anti-AQP4) in Demyelinating disease of Central Nervous System (CNS)-A Case-Control study (P5.226)

Background Clinical studies in South East Asia have shown a high incidence of Optico-spinal syndrome in patients of inflammatory demyelinating diseases of Central nervous system (CNS). It is also observed that the serological marker anti-AQP4 antibody (aquaporin) is less prevalent despite fulfillment of Wingerchuk’s criteria (2006) with longitudinally extensive transverse myelitis (LETM). Objective To study the seropositivity of anti-AQP4 antibody (NMO-IgG) in demyelinating diseases of CNS Methods The study was done at a tertiary level super specialty hospital and A total of 50 patients over 18 years of age attending the outpatient department (OPD) or admitted in the hospital with provisional diagnosis of acute transverse myelitis, longitudinally extensive transverse myelitis (LETM), multiple sclerosis (MS), optic neuritis (ON), clinically isolated syndrome (CIS), optico-spinal syndrome, acute disseminated encephalomyelitis. Patients with a known nutritional or drug induced or hereditary toxic/ neoplastic/ degenerative or any known secondary cause of illness, HIV positive patients, those having a terminal illness/neoplastic/end stage renal or cardiac disease or cirrhosis were excluded from the study. All these patients and Fifty age and sex matched controls were tested for anti-AQP4 antibody. Results Ten percent of subjects and none of the fifty controls were found to be NMO-IgG positive. All seropositive patients had LETM and only 17.6 [percnt] of these satisfied Wingerchuk’s criteria when compared to those without LETM (p=0.008). Conclusion This study provides an overview of the clinical and paraclinical features of NMO spectrum disorder and demonstrates a number of distinct disease characteristics in seropositive and seronegative patients. Study Supported by:research Cell Army hospital R&R Delhi Cantt New Delhi Disclosure: Dr. Gorthi has nothing to disclose. Dr. Mukherjee has nothing to disclose. Dr. cs has nothing to disclose. Dr. sirohi has nothing to disclose.