Clinical Patterns of Neuromyelitis Optica Spectrum Disorders in Assiut University Hospital
Condition: Neuromyelitis Optica Spectrum Disorder
MeSH terms: Neuromyelitis Optica
Study type: Observational

Summary: 
      Neuromyelitis Optica Spectrum Disorders (NMOSD) are a group of inflammatory demyelinating
      disorders of the central nervous system. Although NMOSD occurs much more commonly in nations
      with a predominately non-Caucasian population, NMOSD are underestimated in Egypt and
      frequently misdiagnosed as multiple sclerosis (MS). In this study, by investigating serum
      anti-aquaporin (AQP) 4 and anti-MOG antibody of patients suspected to have NMOSD attending
      the Neurology and Psychiatry department of Assiut University Hospital, investigators aim to
      determine the relative frequency, clinical and radiological characteristics of NMOSD in upper
      Egypt community and compare it with other populations of different races.
    

Detailed description: 
      Neuromyelitis Optica Spectrum Disorders (NMOSD) are a group of inflammatory demyelinating
      disorders of the central nervous system characterized by episodes of immune-mediated
      demyelination and axonal damage mainly involving optic nerves and spinal cord. The discovery
      of a disease-specific serum NMO-immunoglobulin G (IgG) antibody that selectively binds
      aquaporin-4 (AQP4) has not only distinguish NMO from MS but also enabled an appreciation for
      the wide spectrum of this disorder. Another autoantibody is the Myelin oligodendrocyte
      glycoprotein (MOGIgG) antibody that has been increasingly reported in a variety of central
      nervous system neuroinflammatory conditions including patients with phenotypes typical for
      NMOSD. Overall, NMO occurs much more commonly in nations with a predominately non-Caucasian
      population,and estimated to be as high as 10 per 100,000. Differentiation of MS from NMOSD is
      critically important because disease modifying treatment for MS, are inefficacious in or may
      aggravate NMOSD. However, in Africa and Middle East, publications and studies are rare and
      most often focus on isolated cases that clearly do not reflect the epidemiological reality in
      this area. Investigators believe that detailed assessment of serum AQP4 antibody as well as
      anti-MOG antibody in Egyptian patients with suspected NMOSD or those with idiopathic
      inflammatory demyelinating central nervous system diseases (IIDCD) other than typical MS
      would be beneficial and Eventually will help to avoid unnecessary investigations and
      treatments, recurrent and prolonged hospital course, significant morbidity, and even death.
    

Intervention name(s): serum aquaporin 4 antibody (AQP-4-Ab); serum MOG antibody (anti-MOG); MRI brain, spine and orbit
Intervention type(s): Diagnostic Test; Diagnostic Test; Diagnostic Test
Intervention description(s): All patients suspected to have NMOSD according to the recent diagnostic criteria will be examined for serum aquaporin 4 antibody (AQP-4-Ab) and serum myelin oligodendrocyte glycoprotein antibody (anti-MOG); All patients suspected to have NMOSD according to the recent diagnostic criteria will be examined for serum myelin oligodendrocyte glycoprotein antibody (anti-MOG) if they tested negative for serum aquaporin 4 antibody (AQP-4-Ab); All patients suspected to have NMOSD according to the recent diagnostic criteria will have MRI brain, spine and orbit with Gadolinium
Intervention MeSH terms: Antibodies; Immunoglobulins
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        All patients suspected to have NMOSD according to the recent diagnostic criteria attending
        or referred to Neurology and Psychiatry department of Assiut University hospital
      
Keywords: Neuromyelitis Optica Spectrum Disorder; prevalence; anti-AQP4; anti-MOG