Anti-aquaporin 4 IgG (NMO–IgG) Antibodies among Sudanese Patients with Neuromyelitis Optica and Multiple Sclerosis

Marwa  ALamin ¹, Malaz ALamin ², Anas  Ahmed ³, Sharif  Ahmed ⁴, Rayan  Morad ⁵, Wafaa  Ali ⁶

Abstract

 

Introduction: Neuromyelitis optica (NMO) and multiple sclerosis (MS) are distinct autoimmune demyelinating diseases of the central nervous system that impact various populations globally.

Purpose: This study aims to determine the prevalence of NMO-IgG antibodies in Sudanese patients with NMO and to compare their levels to those found in MS patients and individuals with other autoimmune disorders.

Methods: Blood samples from 40 participants, including individuals with NMO, MS, inflammatory control groups, and 20 healthy controls, were collected and analyzed. NMO-IgG antibodies were detected using the Euroimmune indirect immunofluorescence assay.

Results: NMO-IgG antibodies were detected in 86.7% of the NMO group and 6.7% of the MS group, with no antibodies found in the healthy and inflammatory control groups, demonstrating its high diagnostic specificity.

Conclusion: These results highlight the potential clinical value of incorporating NMO-IgG testing into diagnostic protocols. Such integration could greatly enhance the management of NMO in Sudan, providing a practical application of the findings for improved patient care.

^{The Report  :} 

Breaking Ground in Neurology: The Battle Against Neuromyelitis Optica in Low-Resource Settings

By Dr. Marwa Humaida

Neuromyelitis optica (NMO) and multiple sclerosis (MS) have long been mistaken for one another, both being autoimmune disorders that affect the central nervous system (CNS). However, the discovery of anti-aquaporin 4 immunoglobulin G (NMO-IgG) antibodies has been a game-changer, helping to differentiate the two diseases with greater precision. Now, a groundbreaking study from a low-resource setting sheds new light on this often-overlooked condition.

A Closer Look at NMO in Under-Resourced Communities

In regions where access to advanced neurological testing is limited, diagnosing NMO remains a major challenge. This study is among the first to explore the prevalence of NMO-IgG antibodies among patients in such settings. Researchers analyzed blood samples from 40 participants across four groups: NMO patients, MS patients, inflammatory controls, and healthy controls. The goal was to determine how critical NMO-IgG testing is for diagnosing and managing the disease.

Key Findings

• 86.7% of NMO patients tested positive for NMO-IgG, reinforcing its role as a key diagnostic marker.
• Only 6.7% of MS patients showed NMO-IgG positivity, confirming its specificity for NMO.
• Not a single healthy or inflammatory control tested positive for NMO-IgG.

Beyond the numbers, clinical patterns emerged:

• All NMO patients experienced vision impairment, compared to 60% of MS patients.
• Walking difficulties affected 93.3% of NMO cases, demonstrating the disease’s severe impact.
• MRI scans showed clear differences, with most NMO patients exhibiting spinal cord damage, while MS cases had more brain lesions.

What This Means for Healthcare in Low-Resource Settings

For years, diagnosing NMO has been a struggle in low-resource areas, where it is often misclassified as MS due to overlapping symptoms. This study confirms that routine NMO-IgG testing should be prioritized to improve diagnostic accuracy. Early detection can significantly improve treatment outcomes, preventing severe disability.

The Road Ahead

These findings set the stage for change. The next step is to expand research across larger populations and push for the integration of NMO-IgG screening into standard neurology protocols. These diagnostic improvements could transform patient outcomes through earlier intervention and better treatment strategies in resource-limited settings, where specialised neurological care is scarce.

Neurology is advancing globally, and progress is being made even in the most challenging settings—one antibody at a time.

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