Contribution of spinal cord biopsy to diagnosis of aquaporin-4 antibody positive neuromyelitis optica spectrum disorder.

Ringelstein, M; Metz, I; Ruprecht, K; Koch, A; Rappold, J; Ingwersen, J; Mathys, C; Jarius, S; Brück, W; Hartung, H-P; Paul, F; Aktas, O; for the Neuromyelitis Optica Study Group (NEMOS); Langel, Stefan; Oy, Ulrich Hofstadt-van; Reuss, Reinhard; Wilke, Christian; Münch, Christoph; Hellwig, Kerstin; Kleiter, Ingo; Niehaus, Sabine; Melms, Arthur; Linker, Ralf; Mayer, Christoph; Guthke, Kersten; Pellkofer, Hannah; Hoffmann, Frank; Zentner, Christian; Stangel, Martin; Trebst, Corinna; Wildemann, Brigitte; Geis, Christian; Ettrich, Barbara; Bergh, Florian Then; Wandinger, Klaus-Peter; Berthele, Achim; Hemmer, Bernhard; Kümpfel, Tania; Marziniak, Martin; Böttcher, Tobias; Rommer, Paulus S; Neuhaus, Oliver; Sieb, Jörn-Peter; Veauthier, Christian; Faiss, Jürgen; Kern, Peter; Ziemann, Ulf; Tumani, Hayrettin; Lauda, Florian; Brettschneider, Johannes; Liebetrau, Martin; Kleinschnitz, Christoph; Schippling, Sven     «

Ringelstein, M; Metz, I; Ruprecht, K; Koch, A; Rappold, J; Ingwersen, J; Mathys, C; Jarius, S; Brück, W; Hartung, H-P; Paul, F; Aktas, O; for the Neuromyelitis Optica Study Group (NEMOS); Langel, Stefan; Oy, Ulrich Hofstadt-van; Reuss, Reinhard; Wilke, Christian; Münch, Christoph; Hellwig, Kerstin; Kleiter, Ingo; Niehaus, Sabine; Melms, Arthur; Linker, Ralf; Mayer, Christoph; Guthke, Kersten; Pellkofer, Hannah; Hoffmann, Frank; Zentner, Christian; Stangel, Martin; Trebst, Corinna; Wildemann, Bri...     »

Longitudinally extensive transverse myelitis is characteristic but not pathognomonic for neuromyelitis optica spectrum disorders (NMOSDs) and may mimic local tumors. In this retrospective study based on a cohort of 175 NMOSD patients we identified seven patients who initially presented with a longitudinally extensive spinal cord lesion and underwent spinal cord biopsy due to magnetic resonance imaging (MRI)-suspected malignancies. Remarkably, routine neuropathology was inconclusive and did not guide the diagnostic process to anti-aquaporin-4 (AQP4)-seropositive NMOSD. Serious postoperative complications occurred in 5/7 patients and persisted during follow-up in 2/7 patients (29%). Considering these sequelae, AQP4-antibody testing should be mandatory in patients with inconclusive longitudinally extensive spinal cord lesions prior to biopsy.     «

Longitudinally extensive transverse myelitis is characteristic but not pathognomonic for neuromyelitis optica spectrum disorders (NMOSDs) and may mimic local tumors. In this retrospective study based on a cohort of 175 NMOSD patients we identified seven patients who initially presented with a longitudinally extensive spinal cord lesion and underwent spinal cord biopsy due to magnetic resonance imaging (MRI)-suspected malignancies. Remarkably, routine neuropathology was inconclusive and did not g...     »