Clinical and radiological characteristics of neuromyelitis optica spectrum disorder in the North Egyptian Nile Delta

Salama, Sara; Marouf, Hazem; Reda, Mohamed Ihab Samy; Mansour, Amal Refaat; Elkholy, Osama; Lévy, Michaël

doi:10.1016/j.jneuroim.2018.08.014

Cited by 17 publications

(32 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The NMOSD cohort at our institution was predominantly female with an average of 30 years, which is in keeping with what has been found in other studies from Africa [ [13] , [14] , [15] , [16] , [17] ]. Similarly, ON and LETM were the most frequently reported symptoms at relapse presentation, with LETM being the most frequent overall (73%, and the Algerian cohort was 75% [ 17 ]), but the concomitant optico-spinal involvement i.e.…”

Section: Discussionsupporting

confidence: 88%

“…All patients were also commenced on immunosuppression, with mycophenolate and azathioprine being used in the majority of cases as is recommended by NMOSD treatment guidelines [ 5 ], chiefly because of their affordability and availability. In other African cohorts, cyclophosphamide is used more often [ 14 , 15 ], which we tend to avoid given the implications to fertility in a female-predominant disease. Rituximab is generally expensive and not easily available, and was only used in the management of case 8 as they did not like to daily tablets; it is used more frequently for NMOSD in other parts of Africa especially Egypt [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…in a 2013 systematic review of 216 population-based studies, five reported the incidence and prevalence of NMOSD but none were from Africa [ 9 ], and a 2018 review also revealed no prevalence studies from Africa [ 10 ]. Latitude does not seem to be related to NMOSD prevalence [ 11 ], yet to date there are less than 500 cases of NMOSD published from Africa [ 12 ], of which the majority are from North [ [13] , [14] , [15] ] and West [ [16] , [17] , [18] , [19] ] Africa, with a smaller cohort from South Africa [ 20 ] and only one case report from East Africa [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cases of neuromyelitis optica spectrum disorder from the East Africa region, highlighting challenges in diagnostics and healthcare access

Sokhi¹,

Suleiman

Manji

et al. 2021

eNeurologicalSci

View full text Add to dashboard Cite

Background Neuromyelitis optica spectrum disorder (NMOSD) is an auto-immune disease of the central nervous system (CNS) associated with the IgG-antibody against aquaporin-4 (AQP4-IgG). There is little published epidemiology of NMOSD from sub-Saharan Africa (SSA). Methods We retrospectively collated NMOSD cases admitted to our tertiary regional neurology centre. Results We identified 11 cases (10 female, average age 30 years). 64% (7/11) were seropositive for AQP4-IgG, measured using indirect immunofluorescence. The remaining cases could either not afford tests, or had pathognomonic radiological features. 57% (4/7) of seropositive cases had concurrent/recent CNS infection. All patients were treated with high-dose intravenous methylprednisolone (IVMP), and 36% (4/11) also had plasma exchange. Only 55% (6/11) of the patients were seen by a neurologist at presentation: they had less relapses (1.3 vs 2.4), less diagnostic delay (2.3 vs 7.4 months), and were less disabled at the end of our review period. 10 cases were immunosuppressed long-term: 60% on mycophenolate, 30% azathioprine, and one on rituximab. Conclusion Our study is the largest case series of NMOSD from the East Africa region. Patients faced challenges of access to appropriate and affordable testing, and timely availability of a neurologist at onset, which had impacts on their functional outcomes. The majority of the seropositive cases had recent/concurrent CNS infections, suggesting triggered auto-immunity.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cases of neuromyelitis optica spectrum disorder from the East Africa region, highlighting challenges in diagnostics and healthcare access

Sokhi¹,

Suleiman

Manji

et al. 2021

eNeurologicalSci

View full text Add to dashboard Cite

show abstract

“…Moreover, three other patients had a family history of autoimmune disorders. Not only the associated immunologic disorder had been observed, but also positive ANA test was found in 6 patients, two of them also had seropositive for the AQP4 antibody, and anti-ds-DNA was the only weak positive result in one patient [29].…”

Section: Pattern Of Nmosd In the Egyptian Populationmentioning

confidence: 99%

Neuromyelitis optica spectrum standstill in rheumatic systemic autoimmune diseases

Elnady

Fathy

Elkhouly

et al. 2020

Egypt Rheumatol Rehabil

View full text Add to dashboard Cite

Background Neuromyelitis optica spectrum disorders (NMOSD) are considered as an autoantibody-mediated disorder that targets aquaporin-4 (AQP4); other autoantibodies could be detected in such spectrum of diseases, including anti-nuclear antibody and antibodies to extractable nuclear antigens. Systemic autoimmune diseases such as systemic lupus erythematosus (SLE), Sjogren’s syndrome (SS), and other autoimmune diseases can overlap with NMOSD. We aimed in this review to address the current evidence describing the relation of NMOSD to systemic autoimmunity diseases, its controversy of being co-association or the same etiology, and its practical implications. Main body The current review was done using a search for related articles or case reports on PubMed until 2019. The keywords included neuromyelitis optica spectrum disorders in combination with autoimmune disease nomenclature. We described the literature background of this controversy, to summarize the evidence of NMOSD relationship to systemic autoimmune diseases. Conclusion NMOSD associated with systemic autoimmune diseases is more common in SLE and Sjogren’s syndrome rather than other autoimmune diseases, frequently affects females more than males; AQP4 antibodies should be tested for all NMOSD like manifestations associated with an autoimmune disorder; however, the clinical diagnosis of NMOSD regardless of the cord lesion length and the presence of positive AQP4 antibody can occur in systemic autoimmune diseases.

show abstract

“…1 The knowledge about NMOSD has been expanding over the last few years and several studies have been conducted in different nations over the globe to describe various phenotypic and radiological lineaments. [7][8][9] Recent studies demonstrated the presence of IgG antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) in a subset of patients with seronegative NMO. 7,[10][11][12] It was thought that anti-MOG disease primarily affects pediatric cohorts, and has a monophasic course with predilection to optic pathways.…”

Section: Introductionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorders in the Arabian Gulf: challenges and growing experience

Alroughani

Qadi

Inshasi³

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

View full text Add to dashboard Cite

Neuromyelitis optica spectrum disorders (NMOSD) have been studied in different ethnic groups, including Asians, African-Americans, and Caucasians. Demonstrating the clinical features among diverse communities is important to understand the variable disease phenotypes, which will lead to further classification and better clinical management. Testing for antibody against aquaporin-4 (AQP4), the most common target antigen in NMOSD, is not available in many countries and tests use different methods, with variable sensitivity. With negative antibody results, the diagnosis of NMOSD becomes challenging and may affect the outcomes of patients with NMOSD. There are no adequate studies that assess NMOSD cohorts in the Arabian Gulf region, despite the increasing number of diagnosed cases. It is worth assessing NMOSD cohorts in the Arabian Gulf population to study the natural history of disease and to establish an epidemiological background for future perspectives. Various challenges to implement such a mission are outlined, including disease rarity, overlapping presenting symptoms and signs, which posed the issue of mimickers in the differential diagnosis, lack of specialized clinics, absence of highly sensitive testing methods for diagnosis, and the indefinite agreement on the negative AQP4 NMOSD criteria. Collaborative efforts started to take a place among many experts in the region to establish a registry of NMOSD patients for better perception of the disease pattern.

show abstract

Clinical and radiological characteristics of neuromyelitis optica spectrum disorder in the North Egyptian Nile Delta

Abstract: This is the first NMOSD case series in Egypt. Despite some limitation in testing and access to care, there are features of our NMOSD cases that appear to be different from other worldwide cohorts reported in the literature.

Cited by 17 publications

References 33 publications

Cases of neuromyelitis optica spectrum disorder from the East Africa region, highlighting challenges in diagnostics and healthcare access

Cases of neuromyelitis optica spectrum disorder from the East Africa region, highlighting challenges in diagnostics and healthcare access

Neuromyelitis optica spectrum standstill in rheumatic systemic autoimmune diseases

Neuromyelitis optica spectrum disorders in the Arabian Gulf: challenges and growing experience

Contact Info

Product

Resources

About