The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt
Abstract 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 NMO...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-021-02083-1 |
| _version_ | 1818326816234930176 |
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| author | Nirmeen A. Kishk Walaa Abdelfattah Nevin M. Shalaby Hatem S. Shehata Amr Hassan Mohamed I. Hegazy Noha T. Abokrysha Doaa Abdellatif Shereen M. Shawky Sarah S. Abdo Noha Taha Amr M. Fouad Alaa Elmazny Amany H. Ragab |
| author_facet | Nirmeen A. Kishk Walaa Abdelfattah Nevin M. Shalaby Hatem S. Shehata Amr Hassan Mohamed I. Hegazy Noha T. Abokrysha Doaa Abdellatif Shereen M. Shawky Sarah S. Abdo Noha Taha Amr M. Fouad Alaa Elmazny Amany H. Ragab |
| author_sort | Nirmeen A. Kishk |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-13T12:06:23Z |
| format | Article |
| id | doaj.art-abe3c11d298940348166d85508a20804 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-13T12:06:23Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-abe3c11d298940348166d85508a208042022-12-21T23:46:57ZengBMCBMC Neurology1471-23772021-02-012111810.1186/s12883-021-02083-1The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in EgyptNirmeen A. Kishk0Walaa Abdelfattah1Nevin M. Shalaby2Hatem S. Shehata3Amr Hassan4Mohamed I. Hegazy5Noha T. Abokrysha6Doaa Abdellatif7Shereen M. Shawky8Sarah S. Abdo9Noha Taha10Amr M. Fouad11Alaa Elmazny12Amany H. Ragab13Department of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Clinical Pathology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Clinical Pathology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Internal Medicine, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityDepartment of Neurology, Kasr-Alainy Faculty of Medicine, Cairo UniversityAbstract 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.https://doi.org/10.1186/s12883-021-02083-1Neuromyelitis optica spectrum disorderAuaporin4-IgG statusTreatment responseDisability |
| spellingShingle | Nirmeen A. Kishk Walaa Abdelfattah Nevin M. Shalaby Hatem S. Shehata Amr Hassan Mohamed I. Hegazy Noha T. Abokrysha Doaa Abdellatif Shereen M. Shawky Sarah S. Abdo Noha Taha Amr M. Fouad Alaa Elmazny Amany H. Ragab The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt BMC Neurology Neuromyelitis optica spectrum disorder Auaporin4-IgG status Treatment response Disability |
| title | The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt |
| title_full | The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt |
| title_fullStr | The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt |
| title_full_unstemmed | The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt |
| title_short | The aquaporin4-IgG status and how it affects the clinical features and treatment response in NMOSD patients in Egypt |
| title_sort | aquaporin4 igg status and how it affects the clinical features and treatment response in nmosd patients in egypt |
| topic | Neuromyelitis optica spectrum disorder Auaporin4-IgG status Treatment response Disability |
| url | https://doi.org/10.1186/s12883-021-02083-1 |
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