Neuromyelitis optica spectrum disorder (NMOsd) is a group of demyelinating disorders recently redefined and associated with NMO-IgG/anti-aquaporin 4 antibodies. Because NMOsd is of unknown prevalence worldwide, we conducted a retrospective, cross-sectional study of 850 patients with demyelinating disorders hospitalized in North East Tuscany from 1998 to 2006 to examine the prevalence of NMO and related disorders among unselected consecutive neurological patients with inflammatory CNS diseases and to evaluate the clinical phenotype spectrum of identified cases. Clinical data were updated after at least 2 years of follow-up.
View Article and Find Full Text PDFAutoimmune mechanisms are postulated to play a role in the development and progression of dysimmune neuropathies (DN). We investigated the relation between lymphocyte number and marker expression, and disease activity in 20 patients with DN under intravenous immunoglobulins (IVIg) treatment. B- and T-lymphocyte markers were studied by flow cytometry of the expression of CD5, CD25, CD23 and CD38 markers on B cells and of CD3, CD4 and CD8 markers, respectively.
View Article and Find Full Text PDFThe authors retrospectively examined the anti-ganglioside antibody (AGA) IgM level changes from 14 patients with chronic dysimmune neuropathy (5 with multifocal motor neuropathy and 9 with chronic inflammatory demyelinating polyneuropathy) treated with maintenance doses of intravenous immunoglobulins (IVIg). The median follow-up was 5 years. At last follow-up, 93% of the patients had an increment of AGA levels, and five patients with initial AGA values within normal range became positive during follow-up.
View Article and Find Full Text PDFThe available epidemiological data for amyotrophic lateral sclerosis (ALS) support an infectious etiology and lead us to propose a new hypothesis. We examined older epidemiological data concerning categories of the population with increased incidence (aged people, people living in rural areas, farmers, breeders), more recent epidemiological reports regarding Italian soccer players, AIDS patients, people living in highly polluted areas, and reports of cases of conjugal and pregnancy-associated ALS. The toxic and infectious hypotheses lead us to suggest a role for cyanobacteria in the production of endogenous beta-N-methylamino-L-alanine.
View Article and Find Full Text PDFBackground: Azathioprine is an immunosuppressive agent that reduces relapse rates in patients with multiple sclerosis (MS), but its efficacy in suppressing new brain lesions has never been evaluated.
Objective: To evaluate the efficacy of azathioprine therapy on new brain lesion suppression in MS.
Design: Open-label treatment vs baseline study.