Neuropsychiatric Disease and Treatment (Sep 2021)

Effect of Low Complement C4 on Clinical Characteristics of Patients with First-Episode Neuromyelitis Optica Spectrum Disorder

  • Pan C,
  • Zhao Y,
  • Xie H,
  • Zhou Y,
  • Duan R,
  • Li Y,
  • Jia Y,
  • Peng T

Journal volume & issue
Vol. Volume 17
pp. 2859 – 2866

Abstract

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Chunyang Pan, Yi Zhao, Haojie Xie, Yongyan Zhou, Ranran Duan, Yanfei Li, Yanjie Jia, Tao Peng Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of ChinaCorrespondence: Tao PengDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Erqi District, Zhengzhou, Henan Province, People’s Republic of ChinaTel +861 367 366 5072Email [email protected]: To describe and compare the clinical features of patients with first-episode neuromyelitis optica spectrum disorder (NMOSD) in a normal complement C4 group and a low complement C4 group, and explore the mechanism by which low complement C4 affects the clinical features of patients with NMOSD.Patients and Methods: We retrospectively analyzed clinical data of 169 aquaporin-4 (AQP4) antibody positive patients with NMOSD from the First Affiliated Hospital of Zhengzhou University from December 2013 to March 2021. Prior to treatment, the blood was drawn for detection, and the patients underwent a 3.0 Tesla MRI examination. A low complement C4 level was defined as a serum complement C4 level 0.05). The median of discharged EDSS was the same (4 vs 4), but the difference between the two was statistically significant (P = 0.019). Compared with the normal complement C4 group, the blood uric acid level (225 vs 179; P = 0.001) and the C3 level (1.06 vs 0.87, P = 0.000) of the low complement C4 group were significantly lower. The incidence of brainstem lesions in patients with low complement C4 was higher (53.7% vs 33%, P = 0.01).Conclusion: The treatment effect of the first-episode AQP4 antibody positive NMOSD low complement C4 group was poor, the blood-brain barrier was more severely damaged, and the disease changes were likely to involve the brainstem.Keywords: blood-brain barrier, brainstem, humoral immunity, optic neuritis

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