Clinical course of neuromyelitis optica spectrum disorder in a moroccan cohort

Bennis, Anas; Otmani, Hicham El; Benkirane, N.; Harrizi, Ilham; Moutawakil, Bouchra El; Rafai, M.A.

doi:10.1016/j.msard.2019.02.012

Cited by 11 publications

(16 citation statements)

References 41 publications

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“…Abnormal MRI spine findings were seen in 88% of patients, with 44 cases (61.1%) presented with LETM. This was comparable to the frequency of LETM reported in the previous Egyptian series by Salama et al (63.2%, 12/19 patients) 20 and similar to studies from Algeria (75%), 13 Morocco (77.7%), 14 Saudi Arabia (78.3%), 52 Iran (66.1%), 53 Kuwait (64.3%), 25 India (75.2%) 54 as well as several studies from European populations 55 . However, much higher percentage of LETM has been reported in Chinese populations in up to 90.2% of their patients with NMOSD 56 .…”

Section: Discussionsupporting

confidence: 91%

“…In our study abnormal findings were reported in up to 81.1% of brain scans, slightly higher than that reported by the previous Egyptian series (63.2%), 20 Moroccan (71.2%) 14 and Chinese patients (79%) 56 . However, they were much higher than the Irani study and a number of studies from Europe (25–50%) 53,70,71 …”

Section: Discussioncontrasting

confidence: 70%

“…Although patients’ EDSS scores at the last follow up visit showed a wide variation ranging from 0 to 10 with a high mean score of 5.2 ± 2.6, no statistically significant differences could be found between the two groups. Similar scores were reported in studies from Africa, Latin America and Middle East 14,19,20,43,47 . Interestingly, Kitley et al, reported lower disability scores among Asian populations compared to African and Caucasian populations suggesting role of ethnicity in disease course and disability scores 51 …”

Section: Discussionsupporting

confidence: 67%

“…Although initially NMO was not thought to involve the brain, brain involvement in NMOSD has been increasingly reported in the literature in up to 89% of patients with NMOSD in eastern communities, 65,68 while only less than 30% reported in patients from the west. 69 In our study abnormal findings were reported in up to 81.1% of brain scans, slightly higher than that reported by the previous Egyptian series (63.2%), 20 Moroccan (71.2%) 14 and Chinese patients (79%). 56 However, they were much higher than the Irani study and a number of studies from Europe (25-50%).…”

Section: Mri Braincontrasting

confidence: 62%

“…10,11 The variations in clinical and radiological features have been reported among different races as well as between different serostatuses and age groups. 12 Few studies of NMOSD have been reported from Africa and Middle East, [13][14][15][16][17][18][19] and so far in such heavily populated African country like Egypt, only two studies of NMOSD were conducted in Egypt. 20,21 To our knowledge, the detailed radiological characteristics of NMOSD were not studied before among the Egyptian population.…”

mentioning

confidence: 99%

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Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Nasreldein

Farweez

El-Fetoh

et al. 2022

Clinical & Exp Neuroim

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Background Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease of the central nervous system, which mainly affects the optic nerves and the spinal cord. Magnetic resonance imaging (MRI) plays an important role in the diagnosis of NMOSD based on the 2015 consensus criteria. Methods The objective of this study was to describe the MRI characteristics of NMOSD patients in Egypt. This were a prospective, observational study on patients fulfilling the 2015 diagnostic criteria of NMOSD. Patients were recruited consecutively from the Neurology, Psychiatry and Neurosurgery hospital, Assiut University Hospitals, Egypt from March 2019 until August 2020. Data on demographics, clinical and laboratory features were collected. MRI scan results were reviewed for each patient and compared according to Aquaporin4‐seropositivity. Results Ninety patients fulfilled NMOSD diagnostic criteria. The mean age at onset was 30.7±11.8 with a female predominance of 3:1. AQP4 antibodies were positive in 77/90 patients (85.6%). Seventy‐two patients (80%) had acute myelitis, 44 cases (61.1%) had longitudinally extensive transverse myelitis (LETM) and 61 cases (87.1%) had a central position in the cord. Bright spotty lesions (BSL) were found in 44 cases (61.1%). The most common site of cord involvement was the cervical region. Abnormal MRI brain scans were found in 81.1% of patients. No statistically significant differences could be found between the two groups. Conclusion There was a high frequency of abnormal spine and brain MRI findings in the Egyptian population. Even though no specific patterns were typical for AQP4‐specific serostatus, certain findings may suggest NMOSD diagnosis and warrant AQP4‐IgGs testing.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 70%

Section: Discussionsupporting

confidence: 67%

Section: Mri Braincontrasting

confidence: 62%

mentioning

confidence: 99%

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Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Nasreldein

Farweez

El-Fetoh

et al. 2022

Clinical & Exp Neuroim

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Sex ratio and age of onset in AQP4 antibody-associated NMOSD: a review and meta-analysis

Arnett,

Chew,

Leitner

et al. 2024

J Neurol

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Background Aquaporin-4 (AQP4) antibody-associated neuromyelitis optica spectrum disorder (NMOSD) is an antibody-mediated inflammatory disease of the central nervous system. We have undertaken a systematic review and meta-analysis to ascertain the sex ratio and mean age of onset for AQP4 antibody associated NMOSD. We have also explored factors that impact on these demographic data. Methods A systematic search of databases was conducted according to the PRISMA guidelines. Articles reporting sex distribution and age of onset for AQP4 antibody-associated NMSOD were reviewed. An initially inclusive approach involving exploration with regression meta-analysis was followed by an analysis of just AQP4 antibody positive cases. Results A total of 528 articles were screened to yield 89 articles covering 19,415 individuals from 88 population samples. The female:male sex ratio was significantly influenced by the proportion of AQP4 antibody positive cases in the samples studied (p < 0.001). For AQP4 antibody-positive cases the overall estimate of the sex ratio was 8.89 (95% CI 7.78–10.15). For paediatric populations the estimate was 5.68 (95% CI 4.01–8.03) and for late-onset cases, it was 5.48 (95% CI 4.10–7.33). The mean age of onset was significantly associated with the mean life expectancy of the population sampled (p < 0.001). The mean age of onset for AQP4 antibody-positive cases in long-lived populations was 41.7 years versus 33.3 years in the remainder. Conclusions The female:male sex ratio and the mean age of onset of AQP4 antibody-associated NMOSD are significantly higher than MS. The sex ratio increases with the proportion of cases that are positive for AQP4 antibodies and the mean age of onset increases with population life expectancy.

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