Neuromyelitis Optica Spectrum Disorders (NMOSD) and structural renal diseases: A literature review

Abstract

Neuromyelitis Optica Spectrum Disorders (NMOSD) is an immune-mediated disease of the central nervous system that often leads to severe attacks of optic nerves and spinal cord. The discovery of Aquaporine 4 (AQP4) antibody as a potential biomarker of NMOSD has changed the global approach to this disease. There have been associations between NMOSD and systemic autoimmune diseases, both organ specific and non-organ specific. Here, we aimed to review the literature on co-incidence or possible association of kidney diseases with NMOSD.

Methods

we included All English relevant publications (reviews, original articles, case reports, case series and abstracts) from 1998 to 2023 using PubMed and google scholar database for this review.

Results

Nine case reports of co-existing NMOSD with renal disorders were evaluated. The patients were involved from 10–90 years old. The most common association was with nephrotic syndrome and in the context of systemic autoimmune disorders. However a case of NMOSD coincident with renal cell carcinoma without paraneoplastic etiology was reported.

Conclusion

Despite the expression of AQP4 in the collecting duct cells of kidney, whether AQP4-IgG, the pathogenic antibody in NMOSD, can damage to the kidney is still unknown.

Can structural kidney damages lead to AQP4 antigen being exposed to immune system and triggers the cascade of autoimmunity is a question that should be investigated in future studies.