Outcomes After Acute Plasma Exchange for Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.

Background And Objectives: Data on the plasma exchange (PLEX) in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are limited. Herein, we evaluate outcomes after PLEX in MOGAD.

Methods: This international multicenter retrospective cohort study included patients from 18 tertiary care centers in 6 countries.

Relapse and disability outcomes in incident MOGAD patients undergoing watchful waiting after onset.

Background: Observation off chronic steroids-sparing immunotherapy (watchful waiting) is often recommended after the onset attack of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) given the variable relapse risk, but the outcomes of this approach are unexplored.

Objectives: To determine the risk of relapse and unfavorable disability outcomes in MOGAD patients who underwent watchful waiting approach after the onset attack.

Methods: In this international, multicenter, retrospective case series in four tertiary-care centers in Canada, Israel, Thailand, and the United States, patients who fulfilled the 2023 MOGAD diagnostic criteria, presented to the participating institutions with the first clinical attack (incident cases), and had at least 3 years of follow-up were identified (n = 81).

Unemployment, work hour reduction, and income loss: An international, multicentered, cross-sectional study of neuromyelitis optica spectrum disorder.

Objectives: To assess loss of employment, work hours, and wages of people with aquaporin-4 antibody-positive or double-seronegative/antibody status unknown neuromyelitis optica spectrum disorder (NMOSD) internationally.

Methods: An investigator-designed survey was administered to adults ages 18-70 years with NMOSD and distributed by neurologists in 23 countries, July 2022 to September 2023.

Results: There were 897 participants (635 aquaporin-4 antibody positive, 262 double-seronegative/untested; 81.

Real-world data and patient perspectives on the impact of multiple sclerosis, neuromyelitis optica spectrum disorder, and related disorders on employment.

Objective: To examine the impact of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and related disorders on employment and income in Thailand.

Methods: This questionnaire-based cross-sectional study was conducted at Siriraj Hospital in 2023-2024. Primary outcomes included sociodemographic characteristics and employment status.

Reference range for serum neurofilament light chain: findings from healthy Thai adults.

Serum neurofilament light chain is a notable biomarker for detecting axonal injury and has shown significant potential for clinical applications. Establishing a reference interval and cut-off level is a critical step towards implementing a serum neurofilament light chain in routine clinical practice. In this study, we aimed to establish a reference range of serum neurofilament light chains for the Thai population.

Safety and efficacy of programmed cell death-1 inhibitors in relapsed immune-privileged site lymphoma: A systematic review and meta-analysis.

Background: Large B-cell lymphoma of immune-privileged sites (LBCL-IP) is a rare subtype characterized by immune evasion properties. Primary central nervous system lymphoma (PCNSL) and primary testicular lymphoma (PTL) are examples of LBCL-IP associated with programmed cell death protein 1 (PD-1). Few studies have investigated the use of PD-1 inhibitors in patients with relapsed PCNSL and PTL.

Efficacy and safety of rituximab in anti-MuSK myasthenia Gravis: a systematic review and meta-analysis.

This systematic review and meta-analysis evaluated the effectiveness and safety of rituximab in patients with myasthenia gravis harboring antibodies to muscle-specific kinase (anti-MuSK). Four databases were searched from inception to December 23, 2023. We included adult patients (aged ≥ 18 years) who were diagnosed with anti-MuSK myasthenia gravis and who received rituximab.

Clinical manifestations and outcomes of patients with intravascular large B-cell lymphoma with neurological involvement: highlighting longitudinally extensive myelopathy as a distinct feature.

Objective: This study aimed to elucidate the clinical manifestations, laboratory findings and outcomes of patients with intravascular large B cell lymphoma (IVLBCL) with neurological involvement and to differentiate IVLBCL with and without neurological involvement.

Methods: A cohort study was conducted at Siriraj Hospital, Mahidol University, Thailand, between January 2005 and September 2024. Clinical data, laboratory values and central nervous system imaging results were analysed.

Rituximab in secondary progressive multiple sclerosis: a meta-analysis.

Objective: To evaluate the efficacy of rituximab (RTX) in stabilizing disability progression in secondary progressive multiple sclerosis (SPMS).

Methods: A systematic review was conducted, encompassing studies from inception to April 2023, utilizing the MEDLINE and EMBASE databases. Inclusion criteria comprised studies with a minimum of 3 SPMS patients receiving intravenous RTX in at least one infusion, with a follow-up duration of at least 6 months.

Potential neurotoxicity associated with methotrexate.

This study aimed to elucidate the incidence and characteristics of neurotoxicity in patients receiving methotrexate (MTX) treatment. A retrospective analysis was performed using data from the electronic cohort database spanning from January 1990 to December 2021. This review focused on patients who manifested neurotoxic symptoms post-MTX therapy, excluding patients with peripheral neuropathy.

Use of Complementary and Alternative Medicine in Patients With Idiopathic Inflammatory Demyelinating Diseases of the Central Nervous System: A Cross-Sectional Study in Thailand.

Background: Complementary and alternative medications (CAM) are common among patients with multiple sclerosis (MS) for physical and psychological support. However, there is insufficient data regarding the application of CAM in the different cultures and beliefs of each community as well as patient's status.

Objective: To evaluate the prevalence and modalities of the use of CAM among patients with central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDD) in a tertiary care hospital.

Catastrophic tumefactive acute disseminated encephalomyelitis in patient with dengue virus: a case report.

Tumefactive demyelinating lesions (TDL) are a rare occurrence among inflammatory demyelinating diseases of the central nervous system, distinguished by tumor-like lesions exceeding 2 cm in diameter. While various etiologies have been associated with TDL, only a limited number of case reports document the coexistence of acute disseminated encephalomyelitis (ADEM) and TDL. Here, we present the case of a female diagnosed with dengue fever two weeks prior, who subsequently developed left hemiparesis and encephalopathy.

Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder.

In Thailand, resource limitations lead many multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients to use off-label immunosuppressants. This study assesses the efficacy and safety of rituximab (RTX) with a CD19-based reinfusion regimen among Thai MS and NMOSD patients. A retrospective review of patients at the Faculty of Medicine Siriraj Hospital from January 1994 to April 2023 was conducted.

Tumefactive demyelinating lesions: a retrospective cohort study in Thailand.

Tumefactive demyelinating lesions (TDL), characterized by large (≥ 2 cm) demyelinating lesions mimicking tumors, are a rare manifestation of the central nervous system inflammatory demyelinating diseases (CNS-IDD). Distinguishing TDL from other brain lesions can be challenging, often necessitating biopsy or advanced diagnostics. The natural history of TDL varies among races.

Infliximab in neurosarcoidosis: a systematic review and meta-analysis.

Objectives: To evaluate the clinical outcomes and relapse rates in neurosarcoidosis patients administered infliximab.

Methods: A systematic review was conducted using the MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases. The search included studies from their inception to March 2023.

Familial neuromyelitis optica spectrum disorders: Case series and systematic review.

Background: Neuromyelitis optica spectrum disorders (NMOSD) is considered a complex multifactorial disorder. Most cases are sporadic, and familial NMOSD is assumed as a rare occurrence. However, few studies reported familial aggregation of the disorder.

Lymphomatosis cerebri with coexistent anti-N-methyl-D-aspartate receptor antibody: A case report.

Diagnosis of lymphomatosis cerebri (LC) is usually delayed because of its rarity and the need for pathological confirmation. The association of LC with humoral immunity has scarcely been reported. Herein, we present a woman with a 2-week history of dizziness and gait ataxia, followed by diplopia, altered mental status, and spasticity of all limbs.

The epidemiology and burden of neuromyelitis optica spectrum disorder, multiple sclerosis, and MOG antibody-associated disease in a province in Thailand: A population-based study.

Background: Central nervous system inflammatory demyelinating diseases (CNSIDDs) have notable interracial heterogeneity. The epidemiology of CNSIDDs in Thailand, a mainland Southeast Asian country, is unknown.

Objectives: To determine the cumulative incidence, point prevalence, and disease burden of neuromyelitis optica spectrum disorder (NMOSD) and other CNSIDDs in Thailand using population-based data of Chumphon.

Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD.

Inflammatory myelopathies can manifest with a combination of motor, sensory and autonomic dysfunction of variable severity. Depending on the underlying etiology, the episodes of myelitis can recur, often leading to irreversible spinal cord damage and major long-term disability. Three main demyelinating disorders of the central nervous system, namely multiple sclerosis (MS), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders (AQP4+NMOSD) and myelin oligodendrocyte glycoprotein-IgG associated disease (MOGAD), can induce spinal cord inflammation through different pathogenic mechanisms, resulting in a more or less profound disruption of spinal cord integrity.

AQP4-IgG-positive neuromyelitis optica spectrum disorder and temporally detected neoplasms: case report and systematic review.

Background: An increasing number of reports on associations between neoplasms and neuromyelitis optica spectrum disorder (NMOSD) have been published over the past decade. However, types of neoplasms and temporal relationships have not been widely studied.

Objective: To report cases and determine the associations between neoplasms and NMOSD.

Author's response to the commentary: Neuromyelitis optica complicating COVID vaccinations and additional case reports.

Our article Newly diagnosed neuromyelitis optica spectrum disorders following vaccination: Case report and systematic review had instigated a critique that there were more cases of post-COVID-19-vaccination NMOSD. Indeed, after the systematic review was performed in July 2021, many reports have been published, and we have seen two new patients at our center as well. However, Finsterer's question on the subclinical activity of NMOSD prior to vaccination, although an interesting notion, was debatable.

A quarter-century report on neuromyelitis optica spectrum disorder in Thailand: A single-center tertiary care cohort.

Background: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating astrocytopathy with a high relapse-related disability. This is the largest long-term study of Thai NMOSD patients.

Objectives: To compare characteristics and outcomes of aquaporin 4 (AQP4)-IgG-positive and AQP4-IgG-negative patients.