False positivity of anti aquaporin-4 antibodies in natalizumab-treated patients

Abstract

Background:

Neuromyelitis optica spectrum disorders (NMOSD) represent a differential diagnosis of multiple sclerosis (MS). Detection of anti-aquaporin-4 antibodies (AQP4-Ab) is the strongest argument to confirm NMOSD. Diagnosing NMOSD is a major concern because specific MS disease modifying drugs can lead to neurological worsening.

Objective:

To report the case of two natalizumab (NTZ) treated patients who presented a false positive result for AQP4-Ab.

Methods:

A retrospective analysis of NTZ-treated patients who were tested positive for AQP4-Ab in our MS center.

Results:

Two patients treated by NTZ presented a false positive result.

Conclusions:

Clinicians should be aware of potential technical issues in detecting AQP4-Ab in NTZ-treated patients leading to false positive results.

Keywords

Multiple sclerosis natalizumab neuromyelitis optica

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References

Wingerchuk

Banwell

Bennett

. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015; 1–14.

Wang

K-C

Lin

K-H

Lee

T-C

. Poor responses to interferon-beta treatment in patients with neuromyelitis optica and multiple sclerosis with long spinal cord lesions Kira

J-I

. ed. PLoS ONE 2014; 9(6): e98192.

Kleiter

. Failure of natalizumab to prevent relapses in neuromyelitis optica. Arch Neurol 2012; 69(2): 239–245.

Kitley

Evangelou

Küker

. Catastrophic brain relapse in seronegative NMO after a single dose of natalizumab. J Neurol Sci 2014; 1–3.

Polman

Reingold

Edan

. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria.” Ann Neurol 2005; 58(6): 840–846.

Sánchez Gomar

Díaz-Sánchez

Uclés Sánchez

. An immunoassay that distinguishes real neuromyelitis optica signals from a labeling detected in patients receiving natalizumab. BMC Neurol 2014; 14(1): 139.