Objective:

To explore the significance of anti-connective tissue antibodies in the clinical diagnosis and evaluation of neuromyelitis optica spectrum disorder (NMOSD).

Approach:

Key Findings:

• Among the 205 patients, 108 (52.7%) were positive for anti-connective tissue antibodies (CTD abs+).
• Compared with CTD abs− patients, the CTD abs+ group had higher lymphocyte counts, higher monocyte-to-lymphocyte ratios, higher CSF white blood cell counts, and higher CSF immunoglobulin levels.
• CTD abs+ patients exhibited a higher rate of oligoclonal band positivity and a higher proportion with increased 24-hour intrathecal IgG synthesis rate.
• No significant differences in lesion distribution or length of affected spinal cord segments were observed between the two groups.
• CTD abs+ patients had higher Expanded Disability Status Scale scores at first relapse and a higher annualized relapse rate over the 18-month follow-up.

Interpretation:

Limitations:

• The study was limited to patients with AQP4-IgG positivity and did not include those with other CNS demyelinating diseases or diagnosed connective tissue diseases.

Conclusion:

CTD abs positivity in AQP4-IgG-positive NMOSD patients does not predict earlier relapses.

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