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BMC Neurology

, 14:33

Demyelinating diseases


BackgroundA number of reports have described the presence of tuberculosis TB in neuromyelitis optica NMO patients. However, a definite association between the two conditions has not been conclusively demonstrated.

MethodsTo investigate the association between NMO and TB in a Chinese population, we performed a retrospective review of hospital records of NMO patients, control patients and tuberculosis meningitis TBM patients from January 1, 1995 to December 31, 2011.

ResultsThe frequency of preceding-simultaneous active pulmonary TB PTB was not significantly different between NMO patients 1.1% and control groups 2.3% in myasthenia gravis, 1.1% in polymyositis or dermatomyositis, zero in idiopathic facial palsy and viral meningitis-meningoencephalitis. NMO cases differed from TBM cases in terms of demographics, course recurrent or monophasic, cerebrospinal fluid analysis and magnetic resonance images. Two TBM patients shared partial clinical features with NMO one of the TBM patients had a longitudinal extensive spinal cord lesion involving the holocord, and the other had optic neuritis before anti-tuberculosis treatment. NMO antibodies were only detected in NMO patients and not in TBM patients with myelitis or optic neuritis.

ConclusionsWe could not confirm previous suggestions of the association between PTB and NMO. Direct infection of the central nervous system by TB may mimic NMO in some respects, but whether NMO-like symptoms that develop during the course of TB should be considered and diagnosed as NMO is open to discussion.

KeywordsNeuromyelitis optica Tuberculosis NMO-IgG AbbreviationsCNSCentral nervous system

CSFCerebrospinal fluid

LESCLLongitudinal extensive spinal cord lesions

MRIMagnetic resonance imaging

NMONeuromyelitis optica

PTBActive pulmonary tuberculosis


TBMTuberculosis meningitis

TBM-MYTuberculosis meningitis-related myelitis

VMViral meningitis-meningoencephalitis.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-14-33 contains supplementary material, which is available to authorized users.

Rui Li, Xiaonan Zhong contributed equally to this work.

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Autor: Rui Li - Xiaonan Zhong - Wei Qiu - Aimin Wu - Yongqiang Dai - Zhengqi Lu - Xueqiang Hu


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