Nghiên cứu tỷ lệ dương tính tự kháng thể aquaporin-4 trong phổ bệnh viêm tủy thị thần kinh=Prevalence of aquaporin-4 autoantibodies in neuromyelitis optica spectrum disorders

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Tác giả: Minh Nga Cao, Huỳnh Tố Hương Đinh, Nguyễn Trung Thông Lưu, Thị Bích Chi Mai, Hoàng Bắc Nguyễn, Hữu Huy Nguyễn, Thị Băng Sương Nguyễn, Thành Trung Phạm, Kim Phong Vi

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.232-236

Bộ sưu tập: Metadata

ID: 243753

Thêm vào giỏ

Neuromyelitis optica spectrum disorders (NMOSD) are autoimmune diseases of the central nervous system. Characteristic lesions include demyelination of nerve fibers, commonly found in the optic nerve, particularly at the optic chiasm, and at any level of the spinal cord, most frequently in the thoracic spinal cord. In over 80% of cases, NMOSD is caused by autoantibodies (IgG) against the aquaporin-4 channel. Objective: To describe the prevalence of aquaporin-4 autoantibodies (anti-AQP4) in NMOSD patients and to describe the prevalence of myelin oligodendrocyte glycoprotein autoantibodies (anti-MOG) in anti-AQP4- negative patients. Methods: A retrospective review of 75 NMOSD patients at University Medical Center HCMC from January 2022 to July 2024 was conducted. All patients met the diagnostic criteria for NMOSD as defined by the International Panel for NMO Diagnosis 2015. Results: The mean age was 43.6 ± 13.7 years, and females predominated (6.5:1). The majority of patients presented with acute myelitis and optic neuritis. Aquaporin-4 autoantibodies (anti- AQP4) were positive in 54/75 (72%) patients. Among the anti-AQP4-negative patients, 9/21 (42.8%) were positive for anti-MOG. Conclusion: The prevalence of anti-AQP4 was 72%. Anti-MOG testing should be considered in anti-AQP4-negative patients with suspected NMOSD.Phổ bệnh viêm tủy thị thần kinh (Neuromyelitis optica spectrum disorders - NMOSD) là bệnh lý tự miễn của hệ thần kinh trung ương. Tổn thương đặc hiệu là thoái hóa bao Myelin của sợi thần kinh, gặp ở dây thần kinh thị giác mà chủ yếu ở giao thoa thị giác, tổn thương bất cứ nơi nào của tủy sống mà phổ biến nhất là tủy ngực. Trong hơn 80% trường hợp, viêm tủy thị gây ra bởi các tự kháng thể (IgG) với kênh aquaporin 4. Mục tiêu: Mô tả tỷ lệ dương tính tự kháng thể aquaporin-4 (anti-AQP4) trong phổ bệnh viêm tủy thị thần kinh (NMOSD) và mô tả tỷ lệ dương tính tự kháng thể myelin oligodendrocyte glycoprotein (anti-MOG) trong nhóm bệnh nhân âm tính với anti-AQP4. Đối tượng và phương pháp: Mô tả hồi cứu 75 bệnh nhân NMOSD tại Bệnh viện Đại học Y Dược (BV ĐHYD) TP.HCM từ tháng 1 năm 2022 đến tháng 7 năm 2024 thỏa tiêu chuẩn chẩn đoán NMOSD được công bố bởi Hội đồng quốc tế về chẩn đoán NMO năm 2015. Kết quả: độ tuổi trung bình là 43,6 ± 13,7 tuổi
nữ giới chiếm tỷ lệ cao hơn nam giới (6,5:1). Đa số bệnh nhân trong nhóm nghiên cứu có biểu hiện lâm sàng là viêm tủy cấp và viêm thần kinh thị. Có 54/75 (72%) dương tính tự kháng thể aquaporin-4 (anti-AQP4). Trong nhóm âm tính anti-AQP4 có 9/21 (42,8%) dương tính anti-MOG. Kết luận: Tỉ lệ dương tính anti- AQP4 là 72%. Đối với nhóm bệnh nhân âm tính anti-AQP4 cần thực hiện xét nghiệm anti-MOG.

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