Relapsing neuromyelitis optica: demographic and clinical features in Iranian patients.
BACKGROUND
Neuromyelitis Optica (NMO) is a severe inflammatory demyelinating disease of the central nervous system with distinguishing features from multiple sclerosis (MS). NMO has an unknown etiology with poor prognosis in which anti-aquaporin-4 receptor IgG seems to play a major role. The purpose of this study is to represent a clinical and demographic data of NMO in Iranian population.


METHODS
Of 1800 patients attending our MS clinic, 44 patients with NMO were recruited from 2006 to 2009.


RESULTS
Female to male ratio was 3:1 and the disease affected women in younger ages than men (P = 0.04). The median expanded disability status scale score was 3 and the mean duration of symptoms was 4.53 +/- 3.41 (median = 4) years with annual relapse rate of 1.13 year/patient. The most frequent symptoms at presentation were optic neuritis 22 (50%) and transverse myelitis 14 (31.8%). Out of 12 patients whose titer of NMO-IgG was measured, four (30.7%) patients were seropositive. Twenty-eight patients (63%) received azathioprine for a mean duration of 16.84 +/- 27.91 months with significantly lower annual relapse rate (0.4 year/patient).


CONCLUSIONS
Iranian patients as a Caucasian population living in Asia seem to have the same clinical features in comparison with the reported studies from Western countries. Although the duration of follow-up was not too long, but they may possibly have a more benign course.
Sahraian
M A
MA
Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran. msahrai@sina.tums.ac.ir
Moinfar
Z
Z
Khorramnia
S
S
Ebrahim
M Mohammad
MM
D000367:Age Factors; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D001324:Autoantigens / Q000097:blood / Q000276:immunology; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007492:Iran / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009471:Neuromyelitis Optica / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology*; D012008:Recurrence; D013116:Spinal Cord / Q000473:pathology
D051401:Aquaporin 4; D001323:Autoantibodies; D001324:Autoantigens; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents