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

Background: Neuromyelitis optica (NMO) is an autoimmune inflammatory disease of the central nervous system characterized by severe attacks of optic neuritis and longitudinally extensive transverse myelitis. Recently, the demonstration of a pathogenic role for the anti{u2013}aquaporin 4 (AQP4) antibody in NMO has marked a major advance in the understanding o the disease Aim of work: The aim of this study was to report the results of rituximab treatment in NMO spectrum disorders (NMOSDs) Patients and Methods: This was a retrospective observational study conducted on 74 Egyptian patients with NMOSDs. The patients{u2018} data were recruited from patient records in multiple sclerosis (MS) clinics, Neurology Departments, El- Maady Military Hospital (records from 2005) and Cairo University hospitals (Kasr Al-Ainy MS Clinic) (records from 2013) including their full medical history, general and neurological examination, MRI brain and spinal cord results, and laboratory investigation including: immune assays and AQP- 4antibody testing as per MS and MS mimics sheet of Kasr Al-Ainy MS clinic.Results: The study included 74 Patients with NMOSD according to criteria of Wagnerchuck 2015. Both sero-positive and sero-negative anti-aquaporin-4 (AQP-4) antibodies patients were included in the study. The patients were divided into three groups: group 1 (RTX group) included 25 patient; group 2 (AZA group) included 32 patients, and group 3 (Switchers) included 17 patients. Conclusion: our findings suggest that RTX is more effective and safe than AZA in NMO-SD patients. Further studies with larger sample sizes and longer duration of follow-up are reqired to confirm these findings in our country

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