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Uric acid is reduced in demyelinating diseases, including multiple sclerosis and neuromyelitis optica (NMO).Longitudinally extensive transverse myelitis (LETM) is often an early manifestation of NMO.Whether uric acid levels are reduced at presentation of LETM remains unknown.The present study investigated serum uric acid levels by evaluating 35 patients with LETM, 64 with NMO, 62 with multiple sclerosis, 63 Mth other neurological diseases and 65 healthy controls.In addition, we tested the correlation between serum uric acid and the clinical characteristics of LETM.All patients were in the acute phase, defined as less than 1 month from onset or relapse.The results revealed that serum uric acid levels in LETM were significantly lower than in multiple sclerosis, other neurological diseases and healthy controls, but no difference was found between LETM and NMO.A negative correlation between uric acid levels and Expanded Disability Status Scale scores was found in LETM patients (r＝-0.545, P < 0.05).The results suggest that uric acid levels are reduced in patients with LETM, raising the possibility that lower uric acid levels are an indicator of disease disability.Moreover, reduced uric acid levels may be a risk factor in NMO.