Glutamate in neuromyelitis optica / Doaa Abdellatif Mouhamed Elelwany ; Supervised Amany Mahmoud Rabah , Mohamed Elsayed Elawady , Laila Ahmed Rashed

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Background: Neuromyelitis Optica (NMO) is an autoimmune disease that predominantly affects the optic nerves and the spinal cord, it was previously regarded as a variant of multiple sclerosis (MS) and still the distinction between NMO and MS can be sometimes challenging. Objectives: evaluation of the potential usefulness of glutamate as a biomarker in distinguishing NMO from MS patients. Subjects and Methods: this was a case-control study which included 20 NMO patients, 30 MS patients and matched 20 healthy controls, and serum glutamate were measured in different groups. Results: Serum glutamate was significantly higher in NMO patients without relapse (16.78 ± 7.38 og/mL) and NMO patients with relapse (18.40 ± 11.17 og/ml) when compared with controls (3.37 ± 1.28 og/ml, P < 0.01);There was also a significant increase in serum glutamate in NMO patients without relapses (16.78 ± 7.38 og/mL) when compared with MS patients without relapses (10.84 ± 3.26 og/ml, P=0.005), and the cut-off value of the serum glutamate for differentiation between NMO patients without relapses and MS patients without relapses , was > 10.3 og/mL in NMO patients (sensitivity 83.33 % and specificity 60 % , P value = 0.008); glutamate level was also significantly higher in MS patients in relapse (23.69 ± 8.64og/ml) when compared to MS patients without relapse (10.84 ± 3.26 og/ml, P<0.01) and healthy controls(3.37 ± 1.28 og/ml , P<0.01).Conclusion: our study demonstrated the potential value of serum glutamate as a diagnostic biomarker to distinguish NMO patients from MS patients in between relapses.

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