BACKGROUND: In Egypt, the characterization of Neuromyelitis Optica Spectrum Disorder (NMOSD) is lacking. OBJECTIVES: To determine the demographics, clinical features, aquaporin4 antibodies (AQP4-IgG) status, and neuroimaging of Egyptian NMOSD patients. METHODS: Retrospective analysis of 70 NMOSD patients' records from the MS clinic, Kasr Alainy hospital, between January 2013 and June 2018. RESULTS: Patients' mean age was 34.9 ± 9.2 years, and the mean at disease onset was 28.9 ± 10.5 years. Fifty-nine patients had an initial monosymptomatic presentation. AQP4-IgG was measured using either enzyme-linked immunosorbent assay (ELISA) (22 patients) or cell-based assay (CBA) (34 patients). Six and 29 patients had positive results, respectively (p < 0.001). 84% had typical NMOSD brain lesions. Longitudinally extensive myelitis was detected in 49 patients, and 9 had either short segments or normal cords. Treatment failure was higher in seropositive patients. Rituximab significantly reduced the annualized relapse rate (ARR) compared to Azathioprine with a percentage reduction of (76.47 ± 13.28) and (10.21 ± 96.07), respectively (p = 0.04). Age at disease onset was the only independent predictor for disability (p < 0.01). CONCLUSION: Treatment failure was higher in seropositive patients. However, there was no difference in clinical or radiological parameters between seropositive and seronegative patients. Patients, who are polysymptomatic or with older age of onset, are predicted to have higher future disability regardless of the AQP4-IgG status.
BACKGROUND: In Egypt, the characterization of Neuromyelitis Optica Spectrum Disorder (NMOSD) is lacking. OBJECTIVES: To determine the demographics, clinical features, aquaporin4 antibodies (AQP4-IgG) status, and neuroimaging of Egyptian NMOSD patients. METHODS: Retrospective analysis of 70 NMOSD patients' records from the MS clinic, Kasr Alainy hospital, between January 2013 and June 2018. RESULTS:Patients' mean age was 34.9 ± 9.2 years, and the mean at disease onset was 28.9 ± 10.5 years. Fifty-nine patients had an initial monosymptomatic presentation. AQP4-IgG was measured using either enzyme-linked immunosorbent assay (ELISA) (22 patients) or cell-based assay (CBA) (34 patients). Six and 29 patients had positive results, respectively (p < 0.001). 84% had typical NMOSD brain lesions. Longitudinally extensive myelitis was detected in 49 patients, and 9 had either short segments or normal cords. Treatment failure was higher in seropositive patients. Rituximab significantly reduced the annualized relapse rate (ARR) compared to Azathioprine with a percentage reduction of (76.47 ± 13.28) and (10.21 ± 96.07), respectively (p = 0.04). Age at disease onset was the only independent predictor for disability (p < 0.01). CONCLUSION: Treatment failure was higher in seropositive patients. However, there was no difference in clinical or radiological parameters between seropositive and seronegative patients. Patients, who are polysymptomatic or with older age of onset, are predicted to have higher future disability regardless of the AQP4-IgG status.
Authors: Eslam Shosha; Abdulla Al Asmi; Eman Nasim; Jihad Inshasi; Fatima Abdulla; Yaser Al Malik; Ahmed Althobaiti; Mohamed Alzawahmah; Hind A Alnajashi; Mohamed Binfalah; Awad AlHarbi; Ibtisam A Thubaiti; Samar F Ahmed; Jasem Al-Hashel; Mortada Elyas; Ramachandiran Nandhagopal; Arunodaya Gujjar; Talal Al Harbi; Ghadah Al Towaijri; Isa A Alsharooqi; Ahmed AlMaawi; Ali M Al Khathaami; Naser Alotaibi; Shahpar Nahrir; Abdulrahman A Al Rasheed; Mohammed Al Qahtani; Sadaga Alawi; Khalid Hundallah; Mohammed Jumah; Raed Alroughani Journal: Mult Scler Relat Disord Date: 2019-10-19 Impact factor: 4.339
Authors: Maureen A Mealy; Dean M Wingerchuk; Jacqueline Palace; Benjamin M Greenberg; Michael Levy Journal: JAMA Neurol Date: 2014-03 Impact factor: 18.302
Authors: Patrick Waters; Sven Jarius; Edward Littleton; Maria Isabel Leite; Saiju Jacob; Bryony Gray; Ruth Geraldes; Thomas Vale; Anu Jacob; Jacqueline Palace; Susan Maxwell; David Beeson; Angela Vincent Journal: Arch Neurol Date: 2008-07
Authors: Dean M Wingerchuk; Brenda Banwell; Jeffrey L Bennett; Philippe Cabre; William Carroll; Tanuja Chitnis; Jérôme de Seze; Kazuo Fujihara; Benjamin Greenberg; Anu Jacob; Sven Jarius; Marco Lana-Peixoto; Michael Levy; Jack H Simon; Silvia Tenembaum; Anthony L Traboulsee; Patrick Waters; Kay E Wellik; Brian G Weinshenker Journal: Neurology Date: 2015-06-19 Impact factor: 9.910
Authors: Jan-Patrick Stellmann; Markus Krumbholz; Tim Friede; Anna Gahlen; Nadja Borisow; Katrin Fischer; Kerstin Hellwig; Florence Pache; Klemens Ruprecht; Joachim Havla; Tania Kümpfel; Orhan Aktas; Hans-Peter Hartung; Marius Ringelstein; Christian Geis; Christoph Kleinschnitz; Achim Berthele; Bernhard Hemmer; Klemens Angstwurm; Kim Lea Young; Simon Schuster; Martin Stangel; Florian Lauda; Hayrettin Tumani; Christoph Mayer; Lena Zeltner; Ulf Ziemann; Ralf Andreas Linker; Matthias Schwab; Martin Marziniak; Florian Then Bergh; Ulrich Hofstadt-van Oy; Oliver Neuhaus; Uwe Zettl; Jürgen Faiss; Brigitte Wildemann; Friedemann Paul; Sven Jarius; Corinna Trebst; Ingo Kleiter Journal: J Neurol Neurosurg Psychiatry Date: 2017-06-01 Impact factor: 10.154
Authors: Sara Zarei; James Eggert; Laura Franqui-Dominguez; Yonatan Carl; Fernando Boria; Marina Stukova; Alessandro Avila; Cristina Rubi; Angel Chinea Journal: Surg Neurol Int Date: 2018-12-03