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Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.

Identifieur interne : 002461 ( PubMed/Curation ); précédent : 002460; suivant : 002462

Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.

Auteurs : Maciej Jury Czyk [Royaume-Uni] ; Brian Weinshenker [États-Unis] ; Gulsen Akman-Demir [Turquie] ; Nasrin Asgari [Danemark] ; David Barnes [Royaume-Uni] ; Mike Boggild [Australie] ; Abhijit Chaudhuri [Royaume-Uni] ; Marie D'Hooghe [Belgique] ; Nikos Evangelou [Royaume-Uni] ; Ruth Geraldes [Portugal] ; Zsolt Illes [Danemark] ; Anu Jacob [Royaume-Uni] ; Ho Jin Kim [Corée du Sud] ; Ingo Kleiter [Allemagne] ; Michael Levy [États-Unis] ; Romain Marignier [France] ; Christopher Mcguigan [Irlande (pays)] ; Katy Murray [Royaume-Uni] ; Ichiro Nakashima [Japon] ; Lekha Pandit [Inde] ; Friedemann Paul [Allemagne] ; Sean Pittock [États-Unis] ; Krzysztof Selmaj [Pologne] ; Jérôme De Sèze [France] ; Aksel Siva [Turquie] ; Radu Tanasescu [Royaume-Uni] ; Sandra Vukusic [France] ; Dean Wingerchuk [États-Unis] ; Damian Wren [Royaume-Uni] ; Isabel Leite [Royaume-Uni] ; Jacqueline Palace [Royaume-Uni]

Source :

Journal of neurology [ 1432-1459 ] ; 2016.

RBID : pubmed:26530512

Descripteurs français

KwdFr :
- Aquaporine-4 (immunologie), Autoanticorps (sang), Encéphalomyélite aigüe disséminée (anatomopathologie), Encéphalomyélite aigüe disséminée (diagnostic), Encéphalomyélite aigüe disséminée (traitement médicamenteux), Humains, Immunoglobuline G (immunologie), Neuromyélite optique (anatomopathologie), Neuromyélite optique (diagnostic), Neuromyélite optique (traitement médicamenteux), Sclérose en plaques (anatomopathologie), Sclérose en plaques (diagnostic), Sclérose en plaques (traitement médicamenteux), Syndrome.
MESH :
- anatomopathologie : Encéphalomyélite aigüe disséminée, Neuromyélite optique, Sclérose en plaques.
- diagnostic : Encéphalomyélite aigüe disséminée, Neuromyélite optique, Sclérose en plaques.
- immunologie : Aquaporine-4, Immunoglobuline G.
- sang : Autoanticorps.
- traitement médicamenteux : Encéphalomyélite aigüe disséminée, Neuromyélite optique, Sclérose en plaques.
- Humains, Syndrome.

English descriptors

KwdEn :
- Aquaporin 4 (immunology), Autoantibodies (blood), Encephalomyelitis, Acute Disseminated (diagnosis), Encephalomyelitis, Acute Disseminated (drug therapy), Encephalomyelitis, Acute Disseminated (pathology), Humans, Immunoglobulin G (immunology), Multiple Sclerosis (diagnosis), Multiple Sclerosis (drug therapy), Multiple Sclerosis (pathology), Neuromyelitis Optica (diagnosis), Neuromyelitis Optica (drug therapy), Neuromyelitis Optica (pathology), Syndrome.
MESH :
- chemical , blood : Autoantibodies.
- chemical , immunology : Aquaporin 4, Immunoglobulin G.
- diagnosis : Encephalomyelitis, Acute Disseminated, Multiple Sclerosis, Neuromyelitis Optica.
- drug therapy : Encephalomyelitis, Acute Disseminated, Multiple Sclerosis, Neuromyelitis Optica.
- pathology : Encephalomyelitis, Acute Disseminated, Multiple Sclerosis, Neuromyelitis Optica.
- Humans, Syndrome.

Abstract

Distinguishing aquaporin-4 IgG(AQP4-IgG)-negative neuromyelitis optica spectrum disorders (NMOSD) from opticospinal predominant multiple sclerosis (MS) is a clinical challenge with important treatment implications. The objective of the study was to examine whether expert clinicians diagnose and treat NMO/MS overlapping patients in a similar way. 12 AQP4-IgG-negative patients were selected to cover the range of clinical scenarios encountered in an NMO clinic. 27 NMO and MS experts reviewed their clinical vignettes, including relevant imaging and laboratory tests. Diagnoses were categorized into four groups (NMO, MS, indeterminate, other) and management into three groups (MS drugs, immunosuppression, no treatment). The mean proportion of agreement for the diagnosis was low (p o = 0.51) and ranged from 0.25 to 0.73 for individual patients. The majority opinion was divided between NMOSD versus: MS (nine cases), monophasic longitudinally extensive transverse myelitis (LETM) (1), acute disseminated encephalomyelitis (ADEM) (1) and recurrent isolated optic neuritis (RION) (1). Typical NMO features (e.g., LETM) influenced the diagnosis more than features more consistent with MS (e.g., short TM). Agreement on the treatment of patients was higher (p o = 0.64) than that on the diagnosis with immunosuppression being the most common choice not only in patients with the diagnosis of NMO (98 %) but also in those indeterminate between NMO and MS (74 %). The diagnosis in AQP4-IgG-negative NMO/MS overlap syndromes is challenging and diverse. The classification of such patients currently requires new diagnostic categories, which incorporate lesser degrees of diagnostic confidence. Long-term follow-up may identify early features or biomarkers, which can more accurately distinguish the underlying disorder.

DOI: 10.1007/s00415-015-7952-8
PubMed: 26530512

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<author><name sortKey="Barnes, David" sort="Barnes, David" uniqKey="Barnes D" first="David" last="Barnes">David Barnes</name>
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<author><name sortKey="Boggild, Mike" sort="Boggild, Mike" uniqKey="Boggild M" first="Mike" last="Boggild">Mike Boggild</name>
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<author><name sortKey="Chaudhuri, Abhijit" sort="Chaudhuri, Abhijit" uniqKey="Chaudhuri A" first="Abhijit" last="Chaudhuri">Abhijit Chaudhuri</name>
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<author><name sortKey="D Hooghe, Marie" sort="D Hooghe, Marie" uniqKey="D Hooghe M" first="Marie" last="D'Hooghe">Marie D'Hooghe</name>
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<author><name sortKey="Evangelou, Nikos" sort="Evangelou, Nikos" uniqKey="Evangelou N" first="Nikos" last="Evangelou">Nikos Evangelou</name>
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<author><name sortKey="Geraldes, Ruth" sort="Geraldes, Ruth" uniqKey="Geraldes R" first="Ruth" last="Geraldes">Ruth Geraldes</name>
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<author><name sortKey="Illes, Zsolt" sort="Illes, Zsolt" uniqKey="Illes Z" first="Zsolt" last="Illes">Zsolt Illes</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Institute of Clinical Research, Odense, Odense University Hospital, University of Southern Denmark, Odense, Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Neurology, Institute of Clinical Research, Odense, Odense University Hospital, University of Southern Denmark, Odense</wicri:regionArea>
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<author><name sortKey="Jacob, Anu" sort="Jacob, Anu" uniqKey="Jacob A" first="Anu" last="Jacob">Anu Jacob</name>
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<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NMO Clinical Service, The Walton Centre, Liverpool</wicri:regionArea>
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</author>
<author><name sortKey="Kim, Ho Jin" sort="Kim, Ho Jin" uniqKey="Kim H" first="Ho Jin" last="Kim">Ho Jin Kim</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Cancer Center, Seoul, South Korea.</nlm:affiliation>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Neurology, National Cancer Center, Seoul</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kleiter, Ingo" sort="Kleiter, Ingo" uniqKey="Kleiter I" first="Ingo" last="Kleiter">Ingo Kleiter</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Levy, Michael" sort="Levy, Michael" uniqKey="Levy M" first="Michael" last="Levy">Michael Levy</name>
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<wicri:regionArea>Neuromyelitis Optica Clinic, John Hopkins University, 1800 E. Orleans St., Baltimore, MD, 21287</wicri:regionArea>
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</author>
<author><name sortKey="Marignier, Romain" sort="Marignier, Romain" uniqKey="Marignier R" first="Romain" last="Marignier">Romain Marignier</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Mcguigan, Christopher" sort="Mcguigan, Christopher" uniqKey="Mcguigan C" first="Christopher" last="Mcguigan">Christopher Mcguigan</name>
<affiliation wicri:level="1"><nlm:affiliation>University College Dublin, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.</nlm:affiliation>
<country xml:lang="fr">Irlande (pays)</country>
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</affiliation>
</author>
<author><name sortKey="Murray, Katy" sort="Murray, Katy" uniqKey="Murray K" first="Katy" last="Murray">Katy Murray</name>
<affiliation wicri:level="1"><nlm:affiliation>Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, EH16 4SB, UK.</nlm:affiliation>
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<wicri:regionArea>Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, EH16 4SB</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nakashima, Ichiro" sort="Nakashima, Ichiro" uniqKey="Nakashima I" first="Ichiro" last="Nakashima">Ichiro Nakashima</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Tohoku University School of Medicine, Sendai, 980-8574, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Neurology, Tohoku University School of Medicine, Sendai, 980-8574</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pandit, Lekha" sort="Pandit, Lekha" uniqKey="Pandit L" first="Lekha" last="Pandit">Lekha Pandit</name>
<affiliation wicri:level="1"><nlm:affiliation>Nitte University, Mangalore, 575018, Karnataka, India.</nlm:affiliation>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>Nitte University, Mangalore, 575018, Karnataka</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Paul, Friedemann" sort="Paul, Friedemann" uniqKey="Paul F" first="Friedemann" last="Paul">Friedemann Paul</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurology, NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Berlin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pittock, Sean" sort="Pittock, Sean" uniqKey="Pittock S" first="Sean" last="Pittock">Sean Pittock</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Selmaj, Krzysztof" sort="Selmaj, Krzysztof" uniqKey="Selmaj K" first="Krzysztof" last="Selmaj">Krzysztof Selmaj</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Medical University of Lodz, Lodz, Poland.</nlm:affiliation>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Neurology, Medical University of Lodz, Lodz</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="De Seze, Jerome" sort="De Seze, Jerome" uniqKey="De Seze J" first="Jérôme" last="De Sèze">Jérôme De Sèze</name>
<affiliation wicri:level="1"><nlm:affiliation>Neurology Service, University Hospital of Strasbourg, Strasbourg, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Neurology Service, University Hospital of Strasbourg, Strasbourg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Siva, Aksel" sort="Siva, Aksel" uniqKey="Siva A" first="Aksel" last="Siva">Aksel Siva</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.</nlm:affiliation>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tanasescu, Radu" sort="Tanasescu, Radu" uniqKey="Tanasescu R" first="Radu" last="Tanasescu">Radu Tanasescu</name>
<affiliation wicri:level="1"><nlm:affiliation>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vukusic, Sandra" sort="Vukusic, Sandra" uniqKey="Vukusic S" first="Sandra" last="Vukusic">Sandra Vukusic</name>
<affiliation wicri:level="1"><nlm:affiliation>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Wingerchuk, Dean" sort="Wingerchuk, Dean" uniqKey="Wingerchuk D" first="Dean" last="Wingerchuk">Dean Wingerchuk</name>
<affiliation wicri:level="1"><nlm:affiliation>Mayo Clinic Division of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, 13400 E Shea BLVD, Scottsdale, 85259, AZ, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Mayo Clinic Division of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, 13400 E Shea BLVD, Scottsdale, 85259, AZ</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Wren, Damian" sort="Wren, Damian" uniqKey="Wren D" first="Damian" last="Wren">Damian Wren</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Leite, Isabel" sort="Leite, Isabel" uniqKey="Leite I" first="Isabel" last="Leite">Isabel Leite</name>
<affiliation wicri:level="1"><nlm:affiliation>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Palace, Jacqueline" sort="Palace, Jacqueline" uniqKey="Palace J" first="Jacqueline" last="Palace">Jacqueline Palace</name>
<affiliation wicri:level="1"><nlm:affiliation>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK. jacqueline.palace@ndcn.ox.ac.uk.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU</wicri:regionArea>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.</title>
<author><name sortKey="Jury Czyk, Maciej" sort="Jury Czyk, Maciej" uniqKey="Jury Czyk M" first="Maciej" last="Jury Czyk">Maciej Jury Czyk</name>
<affiliation wicri:level="1"><nlm:affiliation>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK. maciej.jurynczyk@ndcn.ox.ac.uk.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Weinshenker, Brian" sort="Weinshenker, Brian" uniqKey="Weinshenker B" first="Brian" last="Weinshenker">Brian Weinshenker</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, 55905, MN, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, 55905, MN</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Akman Demir, Gulsen" sort="Akman Demir, Gulsen" uniqKey="Akman Demir G" first="Gulsen" last="Akman-Demir">Gulsen Akman-Demir</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, School of Medicine, Istanbul Bilim University, Istanbul, Turkey.</nlm:affiliation>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Department of Neurology, School of Medicine, Istanbul Bilim University, Istanbul</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Asgari, Nasrin" sort="Asgari, Nasrin" uniqKey="Asgari N" first="Nasrin" last="Asgari">Nasrin Asgari</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Vejle Hospital and Neurobiology, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Neurology, Vejle Hospital and Neurobiology, Institute of Molecular Medicine, University of Southern Denmark, Odense</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Barnes, David" sort="Barnes, David" uniqKey="Barnes D" first="David" last="Barnes">David Barnes</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Boggild, Mike" sort="Boggild, Mike" uniqKey="Boggild M" first="Mike" last="Boggild">Mike Boggild</name>
<affiliation wicri:level="1"><nlm:affiliation>The Townsville Hospital, 100 Angus Smith Drive, Douglas Qld 4814, Douglas, Townsville, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>The Townsville Hospital, 100 Angus Smith Drive, Douglas Qld 4814, Douglas, Townsville</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Chaudhuri, Abhijit" sort="Chaudhuri, Abhijit" uniqKey="Chaudhuri A" first="Abhijit" last="Chaudhuri">Abhijit Chaudhuri</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Queens Hospital Rom Valley Way, Romford, RM7 0AG, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Neurology, Queens Hospital Rom Valley Way, Romford, RM7 0AG</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="D Hooghe, Marie" sort="D Hooghe, Marie" uniqKey="D Hooghe M" first="Marie" last="D'Hooghe">Marie D'Hooghe</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University Hospital Brussel, Vrije Universiteit Brussel, Brussels, Belgium.</nlm:affiliation>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Department of Neurology, University Hospital Brussel, Vrije Universiteit Brussel, Brussels</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Evangelou, Nikos" sort="Evangelou, Nikos" uniqKey="Evangelou N" first="Nikos" last="Evangelou">Nikos Evangelou</name>
<affiliation wicri:level="1"><nlm:affiliation>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Geraldes, Ruth" sort="Geraldes, Ruth" uniqKey="Geraldes R" first="Ruth" last="Geraldes">Ruth Geraldes</name>
<affiliation wicri:level="1"><nlm:affiliation>Neuroscience Department, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal.</nlm:affiliation>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea>Neuroscience Department, Santa Maria Hospital, University of Lisbon, Lisbon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Illes, Zsolt" sort="Illes, Zsolt" uniqKey="Illes Z" first="Zsolt" last="Illes">Zsolt Illes</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Institute of Clinical Research, Odense, Odense University Hospital, University of Southern Denmark, Odense, Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Neurology, Institute of Clinical Research, Odense, Odense University Hospital, University of Southern Denmark, Odense</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Jacob, Anu" sort="Jacob, Anu" uniqKey="Jacob A" first="Anu" last="Jacob">Anu Jacob</name>
<affiliation wicri:level="1"><nlm:affiliation>NMO Clinical Service, The Walton Centre, Liverpool, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NMO Clinical Service, The Walton Centre, Liverpool</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kim, Ho Jin" sort="Kim, Ho Jin" uniqKey="Kim H" first="Ho Jin" last="Kim">Ho Jin Kim</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Cancer Center, Seoul, South Korea.</nlm:affiliation>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Neurology, National Cancer Center, Seoul</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kleiter, Ingo" sort="Kleiter, Ingo" uniqKey="Kleiter I" first="Ingo" last="Kleiter">Ingo Kleiter</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Levy, Michael" sort="Levy, Michael" uniqKey="Levy M" first="Michael" last="Levy">Michael Levy</name>
<affiliation wicri:level="1"><nlm:affiliation>Neuromyelitis Optica Clinic, John Hopkins University, 1800 E. Orleans St., Baltimore, MD, 21287, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Neuromyelitis Optica Clinic, John Hopkins University, 1800 E. Orleans St., Baltimore, MD, 21287</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Marignier, Romain" sort="Marignier, Romain" uniqKey="Marignier R" first="Romain" last="Marignier">Romain Marignier</name>
<affiliation wicri:level="1"><nlm:affiliation>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Mcguigan, Christopher" sort="Mcguigan, Christopher" uniqKey="Mcguigan C" first="Christopher" last="Mcguigan">Christopher Mcguigan</name>
<affiliation wicri:level="1"><nlm:affiliation>University College Dublin, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.</nlm:affiliation>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>University College Dublin, St. Vincent's University Hospital, Elm Park, Dublin 4</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Murray, Katy" sort="Murray, Katy" uniqKey="Murray K" first="Katy" last="Murray">Katy Murray</name>
<affiliation wicri:level="1"><nlm:affiliation>Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, EH16 4SB, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Chancellor's Building, Edinburgh, EH16 4SB</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nakashima, Ichiro" sort="Nakashima, Ichiro" uniqKey="Nakashima I" first="Ichiro" last="Nakashima">Ichiro Nakashima</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Tohoku University School of Medicine, Sendai, 980-8574, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Neurology, Tohoku University School of Medicine, Sendai, 980-8574</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pandit, Lekha" sort="Pandit, Lekha" uniqKey="Pandit L" first="Lekha" last="Pandit">Lekha Pandit</name>
<affiliation wicri:level="1"><nlm:affiliation>Nitte University, Mangalore, 575018, Karnataka, India.</nlm:affiliation>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>Nitte University, Mangalore, 575018, Karnataka</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Paul, Friedemann" sort="Paul, Friedemann" uniqKey="Paul F" first="Friedemann" last="Paul">Friedemann Paul</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurology, NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Berlin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pittock, Sean" sort="Pittock, Sean" uniqKey="Pittock S" first="Sean" last="Pittock">Sean Pittock</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Selmaj, Krzysztof" sort="Selmaj, Krzysztof" uniqKey="Selmaj K" first="Krzysztof" last="Selmaj">Krzysztof Selmaj</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Medical University of Lodz, Lodz, Poland.</nlm:affiliation>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Neurology, Medical University of Lodz, Lodz</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="De Seze, Jerome" sort="De Seze, Jerome" uniqKey="De Seze J" first="Jérôme" last="De Sèze">Jérôme De Sèze</name>
<affiliation wicri:level="1"><nlm:affiliation>Neurology Service, University Hospital of Strasbourg, Strasbourg, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Neurology Service, University Hospital of Strasbourg, Strasbourg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Siva, Aksel" sort="Siva, Aksel" uniqKey="Siva A" first="Aksel" last="Siva">Aksel Siva</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.</nlm:affiliation>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tanasescu, Radu" sort="Tanasescu, Radu" uniqKey="Tanasescu R" first="Radu" last="Tanasescu">Radu Tanasescu</name>
<affiliation wicri:level="1"><nlm:affiliation>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vukusic, Sandra" sort="Vukusic, Sandra" uniqKey="Vukusic S" first="Sandra" last="Vukusic">Sandra Vukusic</name>
<affiliation wicri:level="1"><nlm:affiliation>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Neurologie A, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Wingerchuk, Dean" sort="Wingerchuk, Dean" uniqKey="Wingerchuk D" first="Dean" last="Wingerchuk">Dean Wingerchuk</name>
<affiliation wicri:level="1"><nlm:affiliation>Mayo Clinic Division of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, 13400 E Shea BLVD, Scottsdale, 85259, AZ, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Mayo Clinic Division of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, 13400 E Shea BLVD, Scottsdale, 85259, AZ</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Wren, Damian" sort="Wren, Damian" uniqKey="Wren D" first="Damian" last="Wren">Damian Wren</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Leite, Isabel" sort="Leite, Isabel" uniqKey="Leite I" first="Isabel" last="Leite">Isabel Leite</name>
<affiliation wicri:level="1"><nlm:affiliation>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Palace, Jacqueline" sort="Palace, Jacqueline" uniqKey="Palace J" first="Jacqueline" last="Palace">Jacqueline Palace</name>
<affiliation wicri:level="1"><nlm:affiliation>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK. jacqueline.palace@ndcn.ox.ac.uk.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU</wicri:regionArea>
</affiliation>
</author>
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<series><title level="j">Journal of neurology</title>
<idno type="eISSN">1432-1459</idno>
<imprint><date when="2016" type="published">2016</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aquaporin 4 (immunology)</term>
<term>Autoantibodies (blood)</term>
<term>Encephalomyelitis, Acute Disseminated (diagnosis)</term>
<term>Encephalomyelitis, Acute Disseminated (drug therapy)</term>
<term>Encephalomyelitis, Acute Disseminated (pathology)</term>
<term>Humans</term>
<term>Immunoglobulin G (immunology)</term>
<term>Multiple Sclerosis (diagnosis)</term>
<term>Multiple Sclerosis (drug therapy)</term>
<term>Multiple Sclerosis (pathology)</term>
<term>Neuromyelitis Optica (diagnosis)</term>
<term>Neuromyelitis Optica (drug therapy)</term>
<term>Neuromyelitis Optica (pathology)</term>
<term>Syndrome</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Aquaporine-4 (immunologie)</term>
<term>Autoanticorps (sang)</term>
<term>Encéphalomyélite aigüe disséminée (anatomopathologie)</term>
<term>Encéphalomyélite aigüe disséminée (diagnostic)</term>
<term>Encéphalomyélite aigüe disséminée (traitement médicamenteux)</term>
<term>Humains</term>
<term>Immunoglobuline G (immunologie)</term>
<term>Neuromyélite optique (anatomopathologie)</term>
<term>Neuromyélite optique (diagnostic)</term>
<term>Neuromyélite optique (traitement médicamenteux)</term>
<term>Sclérose en plaques (anatomopathologie)</term>
<term>Sclérose en plaques (diagnostic)</term>
<term>Sclérose en plaques (traitement médicamenteux)</term>
<term>Syndrome</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Autoantibodies</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Aquaporin 4</term>
<term>Immunoglobulin G</term>
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<term>Neuromyélite optique</term>
<term>Sclérose en plaques</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Encephalomyelitis, Acute Disseminated</term>
<term>Multiple Sclerosis</term>
<term>Neuromyelitis Optica</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Encéphalomyélite aigüe disséminée</term>
<term>Neuromyélite optique</term>
<term>Sclérose en plaques</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Encephalomyelitis, Acute Disseminated</term>
<term>Multiple Sclerosis</term>
<term>Neuromyelitis Optica</term>
</keywords>
<keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Aquaporine-4</term>
<term>Immunoglobuline G</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Encephalomyelitis, Acute Disseminated</term>
<term>Multiple Sclerosis</term>
<term>Neuromyelitis Optica</term>
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<term>Neuromyélite optique</term>
<term>Sclérose en plaques</term>
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<front><div type="abstract" xml:lang="en">Distinguishing aquaporin-4 IgG(AQP4-IgG)-negative neuromyelitis optica spectrum disorders (NMOSD) from opticospinal predominant multiple sclerosis (MS) is a clinical challenge with important treatment implications. The objective of the study was to examine whether expert clinicians diagnose and treat NMO/MS overlapping patients in a similar way. 12 AQP4-IgG-negative patients were selected to cover the range of clinical scenarios encountered in an NMO clinic. 27 NMO and MS experts reviewed their clinical vignettes, including relevant imaging and laboratory tests. Diagnoses were categorized into four groups (NMO, MS, indeterminate, other) and management into three groups (MS drugs, immunosuppression, no treatment). The mean proportion of agreement for the diagnosis was low (p o = 0.51) and ranged from 0.25 to 0.73 for individual patients. The majority opinion was divided between NMOSD versus: MS (nine cases), monophasic longitudinally extensive transverse myelitis (LETM) (1), acute disseminated encephalomyelitis (ADEM) (1) and recurrent isolated optic neuritis (RION) (1). Typical NMO features (e.g., LETM) influenced the diagnosis more than features more consistent with MS (e.g., short TM). Agreement on the treatment of patients was higher (p o = 0.64) than that on the diagnosis with immunosuppression being the most common choice not only in patients with the diagnosis of NMO (98 %) but also in those indeterminate between NMO and MS (74 %). The diagnosis in AQP4-IgG-negative NMO/MS overlap syndromes is challenging and diverse. The classification of such patients currently requires new diagnostic categories, which incorporate lesser degrees of diagnostic confidence. Long-term follow-up may identify early features or biomarkers, which can more accurately distinguish the underlying disorder.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26530512</PMID>
<DateCreated><Year>2016</Year>
<Month>01</Month>
<Day>23</Day>
</DateCreated>
<DateCompleted><Year>2016</Year>
<Month>12</Month>
<Day>14</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>02</Month>
<Day>20</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-1459</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>263</Volume>
<Issue>1</Issue>
<PubDate><Year>2016</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>Journal of neurology</Title>
<ISOAbbreviation>J. Neurol.</ISOAbbreviation>
</Journal>
<ArticleTitle>Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.</ArticleTitle>
<Pagination><MedlinePgn>140-9</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s00415-015-7952-8</ELocationID>
<Abstract><AbstractText>Distinguishing aquaporin-4 IgG(AQP4-IgG)-negative neuromyelitis optica spectrum disorders (NMOSD) from opticospinal predominant multiple sclerosis (MS) is a clinical challenge with important treatment implications. The objective of the study was to examine whether expert clinicians diagnose and treat NMO/MS overlapping patients in a similar way. 12 AQP4-IgG-negative patients were selected to cover the range of clinical scenarios encountered in an NMO clinic. 27 NMO and MS experts reviewed their clinical vignettes, including relevant imaging and laboratory tests. Diagnoses were categorized into four groups (NMO, MS, indeterminate, other) and management into three groups (MS drugs, immunosuppression, no treatment). The mean proportion of agreement for the diagnosis was low (p o = 0.51) and ranged from 0.25 to 0.73 for individual patients. The majority opinion was divided between NMOSD versus: MS (nine cases), monophasic longitudinally extensive transverse myelitis (LETM) (1), acute disseminated encephalomyelitis (ADEM) (1) and recurrent isolated optic neuritis (RION) (1). Typical NMO features (e.g., LETM) influenced the diagnosis more than features more consistent with MS (e.g., short TM). Agreement on the treatment of patients was higher (p o = 0.64) than that on the diagnosis with immunosuppression being the most common choice not only in patients with the diagnosis of NMO (98 %) but also in those indeterminate between NMO and MS (74 %). The diagnosis in AQP4-IgG-negative NMO/MS overlap syndromes is challenging and diverse. The classification of such patients currently requires new diagnostic categories, which incorporate lesser degrees of diagnostic confidence. Long-term follow-up may identify early features or biomarkers, which can more accurately distinguish the underlying disorder.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Juryńczyk</LastName>
<ForeName>Maciej</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Nuffield Department of Clinical Neurosciences, Level 3, West Wing, John Radcliffe Hospital, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK. maciej.jurynczyk@ndcn.ox.ac.uk.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Neurology, Medical University of Lodz, Lodz, Poland. maciej.jurynczyk@ndcn.ox.ac.uk.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Weinshenker</LastName>
<ForeName>Brian</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, 55905, MN, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Akman-Demir</LastName>
<ForeName>Gulsen</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, School of Medicine, Istanbul Bilim University, Istanbul, Turkey.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Asgari</LastName>
<ForeName>Nasrin</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Vejle Hospital and Neurobiology, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Barnes</LastName>
<ForeName>David</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Atkinson Morley's Wing, St George's Hospital, London, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Boggild</LastName>
<ForeName>Mike</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>The Townsville Hospital, 100 Angus Smith Drive, Douglas Qld 4814, Douglas, Townsville, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chaudhuri</LastName>
<ForeName>Abhijit</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Queens Hospital Rom Valley Way, Romford, RM7 0AG, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>D'hooghe</LastName>
<ForeName>Marie</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, University Hospital Brussel, Vrije Universiteit Brussel, Brussels, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Evangelou</LastName>
<ForeName>Nikos</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Division of Clinical Neuroscience, Queens Medical Center, University of Nottingham, Derby Road, Nottingham, NG7 2UH, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Geraldes</LastName>
<ForeName>Ruth</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Neuroscience Department, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Illes</LastName>
<ForeName>Zsolt</ForeName>
<Initials>Z</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, Institute of Clinical Research, Odense, Odense University Hospital, University of Southern Denmark, Odense, Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jacob</LastName>
<ForeName>Anu</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>NMO Clinical Service, The Walton Centre, Liverpool, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kim</LastName>
<ForeName>Ho Jin</ForeName>
<Initials>HJ</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, National Cancer Center, Seoul, South Korea.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kleiter</LastName>
<ForeName>Ingo</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.</Affiliation>
</AffiliationInfo>
</Author>
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	Serveur d'exploration sur les relations entre la France et l'Australie
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Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.

Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.

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