Characteristics and predictors of progression in an Egyptian multiple sclerosis cohort: a multicenter registry study

Abstract

BackgroundMultiple sclerosis (MS) is a complex autoimmune disease with a heterogeneous presentation and diverse disease course. Recent studies indicate a rising prevalence of MS in the Middle East.ObjectiveTo characterize the demographics and disease features of Egyptian patients attending four tertiary referral MS centers in Cairo.Materials and methodsThis was a retrospective, observational study on 1,581 patients between 2001 and 2015. Medical records were reviewed and data were identified and extracted in a standardized electronic registry.ResultsThe mean age of disease onset was 26.6±7.8 years, with the majority being female (2.11:1). Relapsing–remitting MS was the most common type (75.1%). The main presenting symptom was motor weakness (43.9%), which was also the most frequent symptom during the disease course. Family history of MS was found in 2.28%. Higher initial Expanded Disability Status Scale score, black holes, and infratentorial lesions on initial magnetic resonance imaging were independent factors for disease progression by univariate analysis (OR 3.87 [95% CI 1.84–6.51], 4.14 [95% CI 3.08–5.58], 4.07 [95% CI 3.21–4.99], respectively); however, in multivariate analysis, only infratentorial lesions were an independent risk for disease progression (OR 6, 95% CI 2.99–12.02; P=0.0005).ConclusionThe results from this registry – the largest for MS in the Arab region to date – are comparable to other registries with slight differences.

Rising prevalence of multiple sclerosis in Saudi Arabia, a descriptive study

“…The variation in the prevalence could be related to many factors, for example genetic variation, certain environmental factors, role of ethnicity and other variations related to methodologies followed in the different studies; however, the increased prevalence is consistently reported across the different studies conducted globally and in neighboring countries. The female to male ratio in our study was 2:1 nearly similar to the two recent studies conducted in the MENA region, R. Alroughani et al and Hamdy et al, where the female to male ratio was reported at 1.84:1 and 2.14: 1 respectively [15,23]. The mean age at disease onset was 27.8 years, similar to the reported in the overall estimate in a meta-analysis of 52 studies in the MENA region of 28.54 years (27.61-29.48 years) [18].…”

Epidemiology of Multiple sclerosis in Saudi Arabia, a Descriptive study

“…MENA region, R. Alroughani et al and Hamdiet. Al the female to male ratio was reported as 1.84:1 and 2.14: 1 respectively (15,23). The mean age at disease onset was 27.8years, similar to the reported overall estimate in a meta-analysis of 52 studies in the MENA region of 28.54 years (27.61-29.48 years).…”

Magnetic Resonance Spectroscopy in Evaluation of Multiple Sclerosis

“…In Egypt, an observational, retrospective study on 1,581 patients wasdone in 2016 by Hamdy et al, showed that there's a rising prevalence of MS in the Middle East, MS affects individuals during the most productive time of their lives, and directly limits their work capacity, leading to major social and economic consequences; The mean age at MS onset is 26.61±7.82 years, With female dominance. With (female: Male) ratios of (2.14:1) (1) .…”

“…Recent studies indicated a rising prevalence of MS in the Middle East, MS affects individuals during the most productive time of their lives, and directly limits their work capacity, leading to major social and economic consequences; The mean age at MS onset is 26.61±7.82 years, With female dominance. With (female: Male) ratios of (2.14:1) (1) .Multiple sclerosis (MS) is characterized by loss of motor and sensory function that results from immune-mediated inflammation, demyelination and subsequent axonal damage. MS is one of the most common causes of neurological disability in young adults (2) .…”

“…Such metrics are able to reveal a range of tissue changes that include demyelination, axonal loss, iron deposition, and neurodegeneration and they provide the evidence that important occult pathology is occurring in the normal appearing white and gray matter (3) . 1 H-MRS permits the in-vivo study of certain cerebral metabolites thus it offers the possibility of greater pathological specificity in lesional areas of MS as well as in normal appearing white matter and even in the gray matter (4) . The 1 H-MRSI sequence allows an in-vivo evaluation of different cerebral metabolites associated with cellular and functional processes.…”