Treatment of Neuromyelitis Optica With Mycophenolate Mofetil

Abstract

Neuromyelitis optica (NMO) is an idiopathic autoimmune inflammatory demyelinating disorder that affects the central nervous system with a predilection for the optic nerve and spinal cord. It is the first inflammatory autoimmune demyelinating disease of the central nervous system for which a specific antigenic target, the astrocytic water channel aquaporin 4, has been identified.^1,2 Neuromyelitis optica–IgG is an autoantibody specific for this water channel and is a clinically validated serum biomarker that distinguishes relapsing NMO from multiple sclerosis, which has no distinguishing biomarker.³ Patients seropositive for NMO-IgG with either optic neuritis or longitudinally extensive transverse myelitis are considered to have limited forms of NMO, which we have called NMO spectrum disorders. Seropositivity for NMO-IgG in these disorders is predictive of further relapses.^4,5