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Brian G. Weinshenker, MD, FRCPC

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I appreciate the correspondence by the 2 sets of authors who describe patients with 1 or 2 systemic autoimmune diseases who later developed a classic syndrome of relapsing NMO. The association of systemic autoimmunity with NMO has been recognized by us and by others,^1-2 especially in patients with systemic lupus erythematosus and Sjögren disease.³ Neuromyelitis optica may coexist with myasthenia gravis,⁴ idiopathic thrombocytopenic purpura, or multiple autoimmune diseases. The predilection of patients with NMO to develop multiple autoimmune diseases is not understood.

I am pleased to learn how helpful the NMO-IgG serological test has been to these astute clinicians in establishing the etiology for the neurological condition in these patients. I hope that this test will facilitate the care of patients by allowing emerging therapeutic strategies for NMO to be applied to patients with NMO-spectrum disorders, even when they do not satisfy full . . . [Full Text of this Article]

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