Rituximab (RTX) is a monoclonal antibody that targets CD20 on B cells and is used to reduce the relapse risk in neuromyelitis optica spectrum disorder (NMOSD). Some patients experience relapse or exacerbation shortly after RTX treatment. We report a 54-year-old female with seronegative NMOSD who relapsed soon after RTX treatment.
Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are common causes of optic neuritis, typically involving anti-aquaporin 4 (AQP4) and Myelin oligodendrocyte glycoprotein (MOG) antibodies. It is scarce for both AQP4 and MOG antibodies to be simultaneously positive. Although NMOSD and MOGAD share clinical features, they differ in symptoms, magnetic resonance imaging findings and outcomes. Both conditions are treated with steroids and immunoglobulins but exhibit distinct responses. We report a case of NMOSD which was double seropositive for AQP-4 and MOG antibodies.
Autonomic dysfunction occurs frequently in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Patients with either condition may present with autonomic symptoms such as bladder, sexual, cardiovascular, thermoregulatory, and gastrointestinal dysfunction, and fatigue, but autonomic symptoms that affect quality of life are underrecognized in clinical practice. The immunopathogenesis of MS has been considered to be associated with autonomic dysfunction. Applying appropriate treatment strategies for autonomic dysfunction is important to improve the quality of life of patients. Here we review autonomic dysfunction and how this is managed in patients with MS and NMOSD.
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Sexual function and related predictors in male with multiple sclerosis and neuromyelitis optica spectrum disorder: a case–control study Saeed Vaheb, Mohammad Yazdan Panah, Mohammad Mohammadi, Mohammad Amin Sadri, Narges Ebrahimi, Sarina Loghmani, Marjan Beigi, Vahid Shaygannejad, Omid Mirmosayyeb The Journal of Sexual Medicine.2025; 22(2): 274. CrossRef
Background We aimed to investigate candidates for serological biomarkers of neuropathic pain in individuals with neuromyelitis optica spectrum disorder (NMOSD).
Methods We analyzed 38 sera samples from 38 participants with NMOSD in National Cancer Center. Neuropathic pain was evaluated using the painDETECT questionnaire. Pain with neuropathic components (painDETECT score ≥ 13) was observed in 22 participants, among whom 17 had definite neuropathic pain (painDETECT score ≥ 19). The remaining 16 participants had non-neuropathic pain (painDETECT score < 13). Serum glial fibrillary acidic protein (GFAP) levels were assessed using a single-molecule array assay. Several cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-10, and IL-17A, were measured by a multiplex bead-based immunoassay.
Results In comparison of NMOSD participants with neuropathic pain components (or definite neuropathic pain) and those with non-neuropathic pain, the absolute values of serum GFAP, TNF-α, IL-6, and IL-10 levels were higher in participants with neuropathic pain components (or definite neuropathic pain), but these findings did not reach statistical significance.
Conclusions Further larger-scale investigations to find reliable serological biomarkers for neuropathic pain in NMOSD are warranted.
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Neuropathic pain in multiple sclerosis: serum biomarkers and MRI lesion localization Mohamed Hamdy Ismail, Amal SE ELmotayam, Sara F. Saadawy, Rabab M. Elfwakhry, Hebatallah M. Fawzy, Noha T. Sarhan The Egyptian Journal of Neurology, Psychiatry and .2025;[Epub] CrossRef
Shedding light on neuropathic pain: Current and emerging tools for diagnosis, screening, and quantification Anas Hamdan, Rafael Galvez, Majed Katati SAGE Open Medicine.2024;[Epub] CrossRef
Systematic Review and Metanalysis of the Expression of Blood-Based and Cerebrospinal Fluid-Based Biomarkers Related to Inflammatory Mediators in Neuropathic Pain Marina Sanz-Gonzalez, Miguel Molina-Alvarez, Carmen Rodriguez-Rivera, David Pascual, Carlos Goicoechea Journal of Integrative Neuroscience.2024;[Epub] CrossRef
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