Tags

Type your tag names separated by a space and hit enter

Neuromyelitis optica spectrum disorders with antibodies to myelin oligodendrocyte glycoprotein or aquaporin-4: Clinical and paraclinical characteristics in Algerian patients.
J Neurol Sci. 2017 Oct 15; 381:240-244.JN

Abstract

BACKGROUND

Neuromyelitis optica (NMO) is a severe autoimmune inflammatory disorder of the central nervous system. NMO and its abortive forms are referred to as NMO spectrum disorders (NMOSD). NMOSD are mostly associated with antibodies to aquaporin-4 (AQP4-IgG). However, recent studies have demonstrated antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) in a subset of patients. Data on NMOSD in North Africa are sparse.

OBJECTIVE

To describe the frequency of MOG-IgG and AQP4-IgG among patients with optic neuritis (ON) and/or myelitis in Algeria as well as the clinical and paraclinical features associated with these antibodies.

METHODS

Retrospective testing of 42 patients with optic neuritis and/or myelitis treated at the teaching hospital of TiziOuzou for MOG-IgG and AQP4-IgG, and retrospective evaluation of the patients' medical records.

RESULTS

Six of 42 (14.3%) patients were positive for AQP4-IgG and 3/42 (7.1%) were positive for MOG-IgG. No patient was positive for both AQP4-IgG and MOG-IgG. All antibody-positive patients were women. MOG-IgG was associated with severe episodes of ON in all MOG-IgG-positive patients. Steroid treatment was followed by complete remission in two patients. AQP4-IgG was associated with ON and/or longitudinally extensive transverse myelitis (LETM), often with severe onset. While all six of the AQP4-IgG-positive patients met the 2015 IPND criteria for NMOSD, only one of the three MOG-IgG-positive patients did so. Interestingly, clinically silent extensive spinal cord or brain lesions were present in two of the three MOG-IgG-positive patients, and altered visual evoked potentials without clinical evidence of ON were found in three of the six AQP4-IgG-positive patients.

CONCLUSION

MOG-IgG and AQP4-IgG are found in a substantial subset of Algerian patients with ON and/or myelitis, are present predominantly in women, and may be associated with differences in clinical presentation and, possibly, outcome. Only a subset of MOG-IgG positive patients meets the current diagnostic criteria for NMOSD.

Authors+Show Affiliations

Centre hôspitalo-universitaire Nedir Mohamed, Service de Neurologie, Tizi Ouzou, Algeria. Electronic address: bouzarmelissa1@gmail.com.Centre hôspitalo-universitaire Nedir Mohamed, Service de Neurologie, Tizi Ouzou, Algeria.Centre hôspitalo-universitaire Nedir Mohamed, Service de Neurologie, Tizi Ouzou, Algeria.Centre hôspitalo-universitaire Nedir Mohamed, Service de Neurologie, Tizi Ouzou, Algeria.Centre de Référence National des Maladies Neuro-inflammatoires de l'Enfant, Assistance publique-hopitaux de Paris, Hôpitaux Universitaires Paris Sud, site Bicêtre Service de Neuropédiatrie, France.Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Germany.Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28991690

Citation

Bouzar, Melissa, et al. "Neuromyelitis Optica Spectrum Disorders With Antibodies to Myelin Oligodendrocyte Glycoprotein or Aquaporin-4: Clinical and Paraclinical Characteristics in Algerian Patients." Journal of the Neurological Sciences, vol. 381, 2017, pp. 240-244.
Bouzar M, Daoudi S, Hattab S, et al. Neuromyelitis optica spectrum disorders with antibodies to myelin oligodendrocyte glycoprotein or aquaporin-4: Clinical and paraclinical characteristics in Algerian patients. J Neurol Sci. 2017;381:240-244.
Bouzar, M., Daoudi, S., Hattab, S., Bouzar, A. A., Deiva, K., Wildemann, B., Reindl, M., & Jarius, S. (2017). Neuromyelitis optica spectrum disorders with antibodies to myelin oligodendrocyte glycoprotein or aquaporin-4: Clinical and paraclinical characteristics in Algerian patients. Journal of the Neurological Sciences, 381, 240-244. https://doi.org/10.1016/j.jns.2017.08.3254
Bouzar M, et al. Neuromyelitis Optica Spectrum Disorders With Antibodies to Myelin Oligodendrocyte Glycoprotein or Aquaporin-4: Clinical and Paraclinical Characteristics in Algerian Patients. J Neurol Sci. 2017 Oct 15;381:240-244. PubMed PMID: 28991690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuromyelitis optica spectrum disorders with antibodies to myelin oligodendrocyte glycoprotein or aquaporin-4: Clinical and paraclinical characteristics in Algerian patients. AU - Bouzar,Melissa, AU - Daoudi,Smail, AU - Hattab,Samira, AU - Bouzar,Amel A, AU - Deiva,Kumaran, AU - Wildemann,Brigitte, AU - Reindl,Markus, AU - Jarius,Sven, Y1 - 2017/08/31/ PY - 2017/06/26/received PY - 2017/08/24/revised PY - 2017/08/28/accepted PY - 2017/10/10/entrez PY - 2017/10/11/pubmed PY - 2018/6/12/medline KW - Algeria KW - Antibodies KW - Aquaporin-4 (AQP4) KW - Cell-based assay KW - Myelin oligodendrocyte glycoprotein (MOG) KW - Myelitis KW - Neuromyelitis optica spectrum disorders (NMOSD) KW - Optic neuritis SP - 240 EP - 244 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 381 N2 - BACKGROUND: Neuromyelitis optica (NMO) is a severe autoimmune inflammatory disorder of the central nervous system. NMO and its abortive forms are referred to as NMO spectrum disorders (NMOSD). NMOSD are mostly associated with antibodies to aquaporin-4 (AQP4-IgG). However, recent studies have demonstrated antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) in a subset of patients. Data on NMOSD in North Africa are sparse. OBJECTIVE: To describe the frequency of MOG-IgG and AQP4-IgG among patients with optic neuritis (ON) and/or myelitis in Algeria as well as the clinical and paraclinical features associated with these antibodies. METHODS: Retrospective testing of 42 patients with optic neuritis and/or myelitis treated at the teaching hospital of TiziOuzou for MOG-IgG and AQP4-IgG, and retrospective evaluation of the patients' medical records. RESULTS: Six of 42 (14.3%) patients were positive for AQP4-IgG and 3/42 (7.1%) were positive for MOG-IgG. No patient was positive for both AQP4-IgG and MOG-IgG. All antibody-positive patients were women. MOG-IgG was associated with severe episodes of ON in all MOG-IgG-positive patients. Steroid treatment was followed by complete remission in two patients. AQP4-IgG was associated with ON and/or longitudinally extensive transverse myelitis (LETM), often with severe onset. While all six of the AQP4-IgG-positive patients met the 2015 IPND criteria for NMOSD, only one of the three MOG-IgG-positive patients did so. Interestingly, clinically silent extensive spinal cord or brain lesions were present in two of the three MOG-IgG-positive patients, and altered visual evoked potentials without clinical evidence of ON were found in three of the six AQP4-IgG-positive patients. CONCLUSION: MOG-IgG and AQP4-IgG are found in a substantial subset of Algerian patients with ON and/or myelitis, are present predominantly in women, and may be associated with differences in clinical presentation and, possibly, outcome. Only a subset of MOG-IgG positive patients meets the current diagnostic criteria for NMOSD. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/28991690/Neuromyelitis_optica_spectrum_disorders_with_antibodies_to_myelin_oligodendrocyte_glycoprotein_or_aquaporin_4:_Clinical_and_paraclinical_characteristics_in_Algerian_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(17)33755-3 DB - PRIME DP - Unbound Medicine ER -