Abstract
We thank Dr. Shubhakaran for the comments on our article1 that emphasize the risk of giving relevance to thyroid peroxidase (TPO) antibodies when they are probably irrelevant. Shubhakaran et al.2 found a TPO antibody frequency of ∼2.8% in their series of ∼70 patients with myelopathies and neuromyelitis optica spectrum disorders (NMOSD). This figure is not different from that reported in the normal population.3 Indeed, in our study, we included 49 patients—as controls—with NMOSD and aquaporin 4 antibodies, and TPO antibodies were found in 14%.1 In our opinions, the isolated presence of TPO antibodies in a given neurologic syndrome is not an indication for immunotherapy, and all efforts should be focused in finding the real cause of the syndrome.
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