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- Title
A score that predicts aquaporin‐4 IgG positivity in patients with longitudinally extensive transverse myelitis.
- Authors
Campetella, Lucia; Papi, Claudia; Spagni, Gregorio; Sabatelli, Eleonora; Mariotto, Sara; Gastaldi, Matteo; Masi, Gianvito; Carta, Sara; Ahmad, Lara; Rossi, Francesca; Maniscalco, Giorgia Teresa; De Luca, Giovanna; Iorio, Raffaele
- Abstract
Background and purpose: Longitudinally extensive transverse myelitis (LETM) associated with aquaporin‐4 autoantibodies (AQP4‐IgG) can cause severe disability. Early diagnosis and prompt treatment are critical to prevent relapses. A novel score is described based on clinical and neuroimaging characteristics that predicts AQP4‐IgG positivity in patients with LETM. Methods: Patients were enrolled both retrospectively and prospectively from multiple Italian centers. Clinical and neuroimaging characteristics of AQP4‐IgG positive and negative patients were compared through univariate and multivariate analysis. Results: Sixty‐six patients were included. Twenty‐seven (41%) were AQP4‐IgG positive and median age at onset was 45.5 years (range 19–81, interquartile range 24). Female sex (odds ratio [OR] 17.9, 95% confidence interval [CI] 2.6–381.9; p = 0.014), tonic spasms (OR 45.6, 95% CI 3.1–2197; p = 0.017) and lesion hypointensity on T1‐weighted images (OR 52.9, 95% CI 6.8–1375; p = 0.002) were independently associated with AQP4‐IgG positivity. The AQP4‐IgG positivity in myelitis (AIM) score predicted AQP4‐IgG positivity with 85% sensitivity and 95% specificity. Positive and negative likelihood ratios were 16.6 and 0.2 respectively. The inter‐rater and intra‐rater agreement in the score application were both excellent. Conclusions: The AIM score predicts AQP4‐IgG positivity with good sensitivity and specificity in patients with a first episode of LETM. The score may assist clinicians in early diagnosis and treatment of AQP4‐IgG positive LETM.
- Subjects
TRANSVERSE myelitis; NEUROMYELITIS optica; AQUAPORINS; OPTIMISM; DISABILITIES; MULTIVARIATE analysis
- Publication
European Journal of Neurology, 2023, Vol 30, Issue 8, p2534
- ISSN
1351-5101
- Publication type
Article
- DOI
10.1111/ene.15863