Clinical features and sera anti-aquaporin 4 antibody positivity in patients with demyelinating disorders of the central nervous system from Tianjin, China

CNS Neurosci Ther. 2014 Jan;20(1):32-9. doi: 10.1111/cns.12156. Epub 2013 Jul 27.


Aims: To investigate the clinical characteristics and sera anti-aquaporin 4 (AQP4) antibody positivity in patients with inflammatory demyelinating disorders (IDDs) of the central nervous system (CNS) in Tianjin, China.

Methods: We retrospectively evaluated 234 patients with IDDs including neuromyelitis optica (NMO), recurrent optic neuritis (rON), longitudinally extensive transverse myelitis (LETM), clinically isolated syndrome (CIS), and multiple sclerosis (MS) groups. Sera from 217 patients were determined for AQP4-Ab. The clinical characteristics and sera anti-AQP4 positivity were compared.

Results: The IDDS comprised 63 MS, 51 NMO, 56 LETM, 10 rON, and 54 CIS. Compared with MS, NMO had a higher frequency of occurrence in women, intractable hiccup and nausea (IHN), medullospinal lesion, longitudinally extensive spinal cord lesions (LESCL) and bilateral ON, disease onset at a later age, and worsening residual disability. AQP4-Ab-positive rates were 84.1% and 69% in NMO and NMO spectrum disorders (NMOSD), respectively, whereas it was undetectable in all of the MS sera samples.

Conclusions: We comprehensively contrast the distinct clinical features of MS, NMO, and NMOSD in our center. A sensitive AQP4-Ab assay is necessary for the early diagnosis of NMOSD in our patients. Neither medullospinal lesion nor IHN is unique in NMO.

Keywords: Anti-aquaporin 4 antibody; Chinese; Clinical features; Multiple sclerosis; Neuromyelitis optica.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aquaporin 4 / immunology*
  • Autoantibodies / blood*
  • Brain / pathology
  • China / epidemiology
  • Demyelinating Autoimmune Diseases, CNS / epidemiology*
  • Demyelinating Autoimmune Diseases, CNS / immunology*
  • Demyelinating Autoimmune Diseases, CNS / pathology
  • Demyelinating Diseases / epidemiology*
  • Demyelinating Diseases / immunology*
  • Demyelinating Diseases / pathology
  • Female
  • HEK293 Cells
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / epidemiology
  • Multiple Sclerosis / immunology
  • Multiple Sclerosis / pathology
  • Myelitis, Transverse / epidemiology
  • Myelitis, Transverse / immunology
  • Myelitis, Transverse / pathology
  • Neuromyelitis Optica / epidemiology
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / pathology
  • Optic Neuritis / epidemiology
  • Optic Neuritis / immunology
  • Optic Neuritis / pathology
  • Retrospective Studies
  • Spinal Cord / pathology
  • Young Adult


  • AQP4 protein, human
  • Aquaporin 4
  • Autoantibodies