Relapsing Neuromyelitis Optica: demographic and clinical features in Iranian patients

Sahraian, Mohammad Ali; Moinfar, Zahra; Khorramnia, Saeed; Ebrahim, Mina Mohammad

doi:10.1111/j.1468-1331.2009.02928.x

Cited by 37 publications

(21 citation statements)

References 29 publications

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“…The prevalence of anti-AQP4 Ab in NMO patients has ranged from 33% in the Caribbean [27] to 41% in Brazil [20] and 44% in our Taiwanese study, to 52–58% in France [28,29], Japan [16,26] and Germany [30], 60% in Hong Kong [31], the USA [32] and Japan [7], 62–67% in Spain [10], Middle East, Brazil [15] and France [29] and to 90% in the USA [33]. The average annual relapse rate detected in our NMO participants was similar to that in some studies [34,35] and higher than in others [6,20]. The severity of NMO relapses did not significantly correlate with the titer of anti-AQP4 Ab although a trend was noted (p = 0.09) [36].…”

Section: Discussionsupporting

confidence: 62%

The Prevalence of Long Spinal Cord Lesions and Anti-Aquaporin 4 Antibodies in Neuromyelitis Optica Patients in Taiwan

Wang

Tsai²,

Lee³

et al. 2011

Eur Neurol

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Background and Objective: It was the aim of this study to determine the prevalence of anti-aquaporin 4 antibody (anti-AQP4 Ab) and long spinal cord lesions in neuromyelitis optica (NMO) and multiple sclerosis (MS) patients in Taiwan. Asia has a relatively high rate of NMO compared with MS patients. Anti-AQP4 Ab is an important marker for NMO worldwide, but serological data and clinical profiles of NMO patients in Taiwan have not been reported. Methods: This retrospective study compared the clinical symptoms, demographics, spinal cord lesion length and AQP4 Ab status of 34 patients with NMO with 34 patients diagnosed with conventional MS. Results: Our NMO patients were predominantly middle-aged women (median age 45 years), exhibited many relapses (1.0/year) and displayed a higher Expanded Disability Status Scale score (4.75) than conventional MS patients. NMO patients exhibited long spinal cord lesions as detected by MRI. Forty-one percent of the NMO patients had detectable anti-AQP4 Ab. The Expanded Disability Status Scale score was significantly higher in AQP4 Ab– NMO patients. Conclusion: The prevalence of AQP4 Ab in a Taiwanese NMO group was 41%. Long spinal cord lesions and detection of AQP4 Ab helped to differentiate NMO patients from MS patients. Long spinal cord lesions with the anti-AQP4 Ab test may allow for an earlier diagnosis of NMO and improve therapeutic decisions.

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Section: Discussionsupporting

confidence: 62%

The Prevalence of Long Spinal Cord Lesions and Anti-Aquaporin 4 Antibodies in Neuromyelitis Optica Patients in Taiwan

Wang

Tsai²,

Lee³

et al. 2011

Eur Neurol

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“…An epidemiological report in a Cuban population showed a much higher rate in females (0.91) than in males (0.12) [13]. In Iranian and French patients, the female to male ratio was 3:1 and in American patients it was 6.5:1 [10,15,17]. A Brazilian study revealed a female:male ratio of 5:1 [18].…”

Section: Introductionmentioning

confidence: 88%

“…In 1894, Eugène Devic and his student Fernand Gault described 16 patients who had lost vision bilaterally or unilaterally and within weeks developed loss of sphincter control, spastic tetraparesis or paraparesis and loss of sensation [1,[3][4][5][6]17].…”

Section: Clinical Featuresmentioning

confidence: 99%

Epidemiological, clinical, and immunological characteristics of neuromyelitis optica: A review

Pereira

Reiche

Kallaur

et al. 2015

Journal of the Neurological Sciences

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The aim of this study was to review the epidemiological and clinical characteristics of neuromyelitis optica (NMO) and the immunopathological mechanisms involved in the neuronal damage. NMO is an inflammatory demyelinating autoimmune disease of the central nervous system that most commonly affects the optic nerves and spinal cord. NMO is thought to be more prevalent among non-Caucasians and where multiple sclerosis (MS) prevalence is low. NMO follows a relapsing course in more than 80-90% of cases, which is more commonly in women. It is a complex disease with an interaction between host genetic and environmental factors and the main immunological feature is the presence of anti-aquaporin 4 (AQP4) antibodies in a subset of patients. NMO is frequently associated with multiple other autoantibodies and there is a strong association between NMO with other systemic autoimmune diseases. AQP4-IgG can cause antibody-dependent cellular cytotoxicity (ADCC) when effector cells are present and complement-dependent cytotoxicity (CDC) when complement is present. Acute therapies, including corticosteroids and plasma exchange, are designed to minimize injury and accelerate recovery. Several aspects of NMO pathogenesis remain unclear. More advances in the understanding of NMO disease mechanisms are needed in order to identify more specific biomarkers to NMO diagnosis.

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“…Additional studies of azathioprine have reported similar results. Bichuetti et al (79) noted a decrease in the ARR from 2.1 to 0.6 during therapy (2 mg/kg/day with or without steroids) in their retrospective analysis, and Sahraian et al (80) reported a reduction in the ARR from 1.13 to 0.4 (3 mg/kg/day) in their small prospective cohort.…”

Section: Neuromyelitis Optica Therapymentioning

confidence: 98%

The Treatment of Neuromyelitis Optica

Kowarik¹,

Soltys²,

Bennett³

2014

Journal of Neuro-Ophthalmology

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Neuromyelitis optica (NMO) is an autoimmune disorder of the central nervous system directed against astrocytes. Initially diagnosed in individuals with monophasic or relapsing optic neuritis and transverse myelitis, NMO is now recognized as a demyelinating disorder with pleiotropic presentations due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 in the majority of individuals. As visual impairment and neurologic dysfunction in NMO are commonly severe, aggressive treatment of relapses and prophylactic immunomodulatory therapy are the focus of treatment. Although there are no approved treatments for NMO, medications and therapeutic interventions for acute and chronic treatment have been the subject of retrospective study and case reports. The goal of this review is to familiarize the reader with biologic and clinical data supporting current treatments in NMO and highlight future strategies based on advancements in our understanding of NMO pathogenesis.

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Relapsing Neuromyelitis Optica: demographic and clinical features in Iranian patients

Abstract: Iranian patients as a Caucasian population living in Asia seem to have the same clinical features in comparison with the reported studies from Western countries. Although the duration of follow-up was not too long, but they may possibly have a more benign course.

Cited by 37 publications

References 29 publications

The Prevalence of Long Spinal Cord Lesions and Anti-Aquaporin 4 Antibodies in Neuromyelitis Optica Patients in Taiwan

The Prevalence of Long Spinal Cord Lesions and Anti-Aquaporin 4 Antibodies in Neuromyelitis Optica Patients in Taiwan

Epidemiological, clinical, and immunological characteristics of neuromyelitis optica: A review

The Treatment of Neuromyelitis Optica

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