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What Is the True Clinicopathologic Spectrum of Neuromyelitis Optica?—Reply

Benjamin M. Greenberg, MD, MHS; Dean Wingerchuk, MD; Maureen Mealy, RN; Michael Levy, MD, PhD
JAMA Neurol. 2013;70(2):272-273. doi:10.1001/jamaneurol.2013.1286.
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We appreciate the comments of Drs Govindarajan and Salgado relative to our article about the clinicopathologic spectrum of neuromyelitis optica (NMO)/NMO spectrum disorder. They point out 2 other potential clinical manifestations of NMO and question the conclusions relative to natalizumab and interferon therapy.

The cases presented do indeed represent potential presentations for NMO. The first case describes a patient who presented with clinical and radiographic evidence of myeloradiculitis and whose test results were subsequently found to be positive for the anti–aquaporin 4 (AQP4) antibody. The second case involves a patient with generalized pruritus preceding myelitis and whose test results were positive for anti-AQP4 antibody. While our case series did not specifically record these patient types, it is worth noting 2 observations.

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February 1, 2013
Raghav Govindarajan, MD; Efrain Salgado, MD
JAMA Neurol. 2013;70(2):272-273. doi:10.1001/jamaneurol.2013.963.
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