Analysis Of Clinical Characteristics Of Optic Neuromyelitis Pedigree Diseases Complicated With Non Organ Specific Autoantibodies Autoantibody Positive

Objective:To explore the clinical characteristics of nmosd patients with positive non organ specific autoantibodies by comparing the clinical and hematological indexes of patients with different non organ specific autoantibodies.Methods:A total of 169 patients who met the diagnostic criteria of adult NMOSD in the second Hospital of Hebei Medical University from January 2015 to September 2020 were included.The basic data,medical history and blood test results were collected.According to the results of non organ specific autoantibody detection,161patients were divided into three groups:(1)negative group:NMOSD patients without common autoantibodies.(2)ANA positive group:ANA positive patients without SSA and SSB positive patients.(3)ANA and SSA/SSB positive group:ANA positive and SSA/SSB positive,among which SSB positive patients were all accompanied by SSA positive.Retrospective study and statistical analysis of the clinical characteristics of patients with different autoantibodies.Results:1.The most common non-organ specific autoantibodies in NMOSD patients were ANA and SSA;with ANA positive in 86 cases(50.9%),SSA positive in 44 cases(26.0%),and SSB positive in 9 cases(5.3%).All of the 9 patients with SSB positive were also SSA positive.2.There were more female patients with NMOSD,accounting for about 82.2%.Compared with NMOSD patients who were not organ-specific autoantibody positive,the proportion of female patients with ANA and SSA/SSB was higher,and the difference was statistically significant(P<0.05).3.The median discharge EDSS score of NMOSD patients was 1.0(1.0～2.0).There was significant difference in discharge EDSS score between negative group and ANA and SSA/SSB positive group(P<0.05).The discharge EDSS score of patients with ANA and SSA/SSB positive was higher,but there was no difference in admission EDSS score among each group.4.The positive rate of AQP4 IgG in nmosd patients was 79.9%.There were significant differences between each group.Compared with negative group,Ana positive group,ANA and SSA/SSB positive group were more likely to have AQP4 IgG positive(P<0.05).5.The serum IgG level was higher and the lymphocyte level was lower in ANA positive NMOSD patients and ANA+SSA/SSB positive NMOSD patients(P<0.05),and the serum IgA level in ANA+SSA/SSB positive patients was significantly higher than that in ANA+SSA/SSB positive patients(P<0.05).Conclusions:1.ANA and SSA are the most common non organ specific autoantibodies in patients with nmosd.Patients with positive ANA in nmosd and patients with both ANA and SSA/SSB in nmosd are more likely to have positive AQP4 antibodies.2.Compared with nmosd patients without non organ specific autoantibodies,patients with Ana positive or ANA and SSA/SSB positive had higher EDSS scores after acute treatment,suggesting that the effect of conventional treatment in acute stage was relatively poor.