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Neuromyelitis optica spectrum disorders in Arabian Gulf (NMOAG); establishment and initial characterization of a patient registry

2019; Elsevier BV; Volume: 38; Linguagem: Inglês

10.1016/j.msard.2019.101448

2211-0356

Eslam Shosha, Abdulla Al‐Asmi, Eman Nasim, Jihad Inshasi, Фатима Абдулла, Yaser Al Malik, Ahmed Althobaiti, Mohamed Alzawahmah, Hind Alnajashi, Mohamed Binfalah, Awad S. Alharbi, Ibtisam A. Al Thubaiti, Samar Farouk Ahmed, Jasem Al–Hashel, Mortada Elyas, Ramachandiran Nandhagopal, Arunodaya R. Gujjar, Talal Al‐Harbi, Ghadah Al Towaijri, Isa A Alsharooqi, Ahmed AlMaawi, Ali M. Al Khathaami, Naser Alotaibi, Shahpar Nahrir, A. A. Rasheed, Mohammed Al Qahtani, Sadaga Alawi, Khalid Hundallah, Mohammed Al Jumah, Raed Alroughani,

Ocular Diseases and Behçet’s Syndrome

Abstract Objective To describe the clinical and radiological characteristics of neuromyelitis optica spectrum disorders (NMOSD) patients from the Arabian Gulf relative to anti-aquaporin 4 antibody serostatus. Methods Retrospective multicentre study of hospital records of patients diagnosed with NMOSD based on 2015 International Panel on NMOSD Diagnosis (IPND) consensus criteria. Results One hundred forty four patients were evaluated, 64.3% were anti-AQP4 antibody positive. Mean age at onset and disease duration were 31±12 and 7 ± 6 years respectively. Patients were predominantly female (4.7:1). Overall; relapsing course (80%) was more common than monophasic (20%). Optic neuritis was the most frequent presentation (48.6%), regardless of serostatus. The proportion of patients (54.3%) with visual acuity of ≤ 0.1 was higher in the seropositive group ( p = 0.018). Primary presenting symptoms of transverse myelitis (TM) were observed in 29% of patients, and were the most significant correlate of hospitalization ( p <0.001). Relative to anti-APQ4 serostatus, there were no significant differences in terms of age of onset, course, relapse rates or efficacy outcomes except for oligoclonal bands (OCB), which were more often present in seronegative patients (40% vs.22.5%; p = 0.054). Irrespective of serostatus, several disease modifying therapies were instituted including steroids or immunosuppressives, mostly, rituximab and azathioprine in the cohort irrespective of serostatus. The use of rituximab resulted in reduction in disease activity. Conclusion This is the first descriptive NMOSD cohort in the Arabian Gulf region. Seropositive patients were more prevalent with female predominance. Relapsing course was more common than monophasic. However, anti-AQP4 serostatus did not impact disease duration, relapse rate or therapeutic effectiveness. These findings offer new insights into natural history of NMOSD in patients of the Arabian Gulf and allow comparison with patient populations in different World regions.