Neurology · 2 h ago
Double-seronegative NMOSD represented 8.4% of a Korean cohort
A multicenter retrospective cohort study at four Korean referral centers assessed 634 people meeting 2015 NMOSD criteria, using cell-based assays and repeat testing for initially seronegative cases. Double-seronegative NMOSD accounted for 8.4%; most affected patients had a relapsing course and received maintenance immunosuppression.
- DN-NMOSD accounted for 8.4% of 634 NMOSD cases.
- Median onset age was 36; 59% were female.
- 93% had a relapsing course over median nine-year follow-up.
- Treatment-associated relapse reduction does not establish causality.
Researchers retrospectively analyzed 634 people who met the 2015 diagnostic criteria for neuromyelitis optica spectrum disorder (NMOSD) at four Korean referral centers. AQP4-IgG and MOG-IgG were assessed using cell-based assays, with repeat testing in people initially found to be seronegative. The study aimed to estimate the proportion and describe the clinical characteristics of double-seronegative NMOSD (DN-NMOSD).
DN-NMOSD accounted for 53 of 634 cases (8.4%). Median age at onset was 36 years, and 59% were female. At onset, simultaneous optic neuritis and myelitis was reported in 2%, while isolated brain involvement without myelitis, optic neuritis, or area postrema syndrome occurred in 13%. During a median nine-year follow-up, 93% had a relapsing course. Maintenance immunosuppressive therapy was used in 91%; relapse rates decreased after treatment (p<0.001).
The findings describe DN-NMOSD under stringent application of earlier diagnostic criteria and repeated antibody testing, and may inform discussions of its classification in evolving criteria. The retrospective cohort was drawn from Korean referral centers, and the reported association between treatment and fewer relapses does not establish treatment causality.
In practice
This cohort indicates that DN-NMOSD was uncommon (8.4%) among patients meeting 2015 NMOSD criteria after cell-based antibody testing and repeat assessment of initially seronegative cases. The high proportion with relapses over follow-up describes the burden in this referral-center population, but the study does not establish that maintenance immunosuppression caused the observed post-treatment reduction in relapse rates. Its retrospective design and Korean referral-center setting limit generalizability; it does not establish a change in treatment or diagnostic practice.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
European Journal of Neurology: Proportion and Clinical Characteristics of Double‐Seronegative NMOSD in a Multicenter Real‐World Cohort ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.