Centre hôspitalo-universitaire Nedir Mohamed, Service de Neurologie, Tizi Ouzou, Algeria.
Centre hôspitalo-universitaire Nedir Mohamed, Service de Neurologie, Tizi Ouzou, Algeria.
J Neurol Sci. 2017 Oct 15;381:240-244. doi: 10.1016/j.jns.2017.08.3254. Epub 2017 Aug 31.
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.
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.
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.
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.
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.
视神经脊髓炎（NMO）是一种严重的中枢神经系统自身免疫性炎症性疾病。NMO 及其顿挫型被称为 NMO 谱疾病（NMOSD）。NMOSD 主要与水通道蛋白 4（AQP4-IgG）抗体相关。然而，最近的研究表明，在一部分患者中存在髓鞘少突胶质细胞糖蛋白（MOG-IgG）抗体。北非的 NMOSD 数据很少。
描述在阿尔及利亚，视神经炎（ON）和/或脊髓炎患者中 MOG-IgG 和 AQP4-IgG 的频率，以及与这些抗体相关的临床和实验室特征。
对在提济乌祖教学医院接受治疗的 42 例 ON 和/或脊髓炎患者进行 MOG-IgG 和 AQP4-IgG 的回顾性检测，并对患者的病历进行回顾性评估。
42 例患者中，6 例（14.3%）AQP4-IgG 阳性，3 例（7.1%）MOG-IgG 阳性。没有患者同时 AQP4-IgG 和 MOG-IgG 阳性。所有抗体阳性患者均为女性。在所有 MOG-IgG 阳性患者中，MOG-IgG 与严重的 ON 发作有关。在两名患者中，类固醇治疗后完全缓解。AQP4-IgG 与 ON 和/或长节段横贯性脊髓炎（LETM）相关，常伴有严重起病。虽然 6 例 AQP4-IgG 阳性患者均符合 2015 年 NMOSD 的 IPND 标准，但仅 3 例 MOG-IgG 阳性患者中的 1 例符合。有趣的是，在 3 例 MOG-IgG 阳性患者中有 2 例存在临床无症状的广泛脊髓或脑内病变，在 6 例 AQP4-IgG 阳性患者中有 3 例存在视觉诱发电位改变而无 ON 的临床证据。
MOG-IgG 和 AQP4-IgG 在相当一部分阿尔及利亚 ON 和/或脊髓炎患者中存在，主要见于女性，且可能与临床表现和（可能）结局的差异有关。只有一部分 MOG-IgG 阳性患者符合 NMOSD 的现行诊断标准。
