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Testing for Neuromyelitis Optica



April 2010

Beyond Hot Topic is an opportunity for viewers to ask questions of the Hot Topic presenter.

For this Beyond Hot Topic, a conference call was held April 15, 2010 at 2:00pm CST. The questions presented below are unedited.

Transcript

Good afternoon and welcome to Mayo Medical Laboratories’ Beyond Hot Topic. Our program today is a follow-up to the Hot Topic: Testing for Neuromyelitis Optica. Our presenter is Dr. Sean Pittock. Dr. Pittock is the Co-Director of the Clinical Neuroimmunology Laboratory and an Associate Professor in the Departments of Neurology and Laboratory Medicine and Pathology at Mayo Clinic.

  1. Are there certain populations that are more likely to develop NMO than others? If so, are there some unique reasons why a population (sex, race, etc.) would have a higher prevalence?

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  2. If someone is in a higher risk category for potentially developing NMO, are there preventative measures that they can pursue?

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  3. Could Dr. Pittock provide a story of how this test has improved his efficacy in identifying patients with NMO? For instance, before NMO-IgG was found, how much time and effort did it take to get to the diagnosis that the patient had NMO.

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  4. Can you describe some of the downstream costs that are associated with the misdiagnosis of MS for patients who really have NMO?

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  5. Are there different assays available for NMO-IgG testing? Which is best?

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  6. How would you incorporate a positive NMO-IgG test into your therapeutic decision making?

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  7. Since this is a CNS disorder, is it better to test CSF (spinal fluid) than serum?

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  8. Do false-positive results for NMO-IgG occur?

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  9. Dr. Pittock described additional symptoms for children such as vomiting and nausea. Are there additional symptoms for adults as well?

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  10. How can you identify if this is the patient’s first attack or the second or the third? Are the attacks severe enough that they require hospitalization?

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