Retrospective analysis of children with myelin oligodendrocyte glycoprotein antibody-related disorders

Mult Scler Relat Disord. 2018 Nov:26:1-7. doi: 10.1016/j.msard.2018.07.022. Epub 2018 Sep 10.

Abstract

Background: Knowledge has been expanding on myelin oligodendrocyte glycoprotein (MOG) antibody-associated central nervous system disorders. We delineate the clinical and paraclinical findings and outcome of our pediatric patients with MOG antibody seropositive disease.

Methods: We retrospectively analyzed the clinical presentation, cerebrospinal fluid findings, magnetic resonance imaging (MRI) studies, course and outcome of children seropositive for anti-MOG IgG.

Results: Total 20 children with neurological symptoms and serum anti-MOG IgG were identified from six centers in Turkey. Median age at onset was 9 years (mean 8.8 ± 5.0 years, range: 1.5-16.5 years). Final diagnoses were acute disseminated encephalomyelitis (ADEM) (n = 5), ADEM + optic neuritis (n = 4), neuromyelitis optica spectrum disorder (NMOSD) (n = 3), myelitis (n = 2), relapsing optic neuritis (n = 2), multiphasic DEM (n = 3), and unclassified relapsing demyelinating disease (n = 1). Seven/20 (35%) children experienced a single episode while 13/20 (65%) had a least one relapse during follow-up. On MRI, subcortical white matter, brainstem, and corpus callosum were preferentially involved regions. Full recovery was observed in 15/20 (75%) children.

Conclusion: MOG autoimmunity in children has a wide clinical spectrum, tendency to relapse, and a favourable outcome compared with other relapsing demyelinating diseases.

Keywords: Antibody; Demyelinating diseases; MRI; Myelin oligodendrocyte glycoprotein; Neuroimmunology.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Autoantibodies / blood*
  • Brain Stem / diagnostic imaging
  • Brain Stem / pathology*
  • Child
  • Child, Preschool
  • Demyelinating Autoimmune Diseases, CNS / blood
  • Demyelinating Autoimmune Diseases, CNS / diagnosis*
  • Demyelinating Autoimmune Diseases, CNS / immunology*
  • Demyelinating Autoimmune Diseases, CNS / pathology
  • Encephalomyelitis, Acute Disseminated / blood
  • Encephalomyelitis, Acute Disseminated / diagnosis
  • Encephalomyelitis, Acute Disseminated / immunology
  • Encephalomyelitis, Acute Disseminated / pathology
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Myelin-Oligodendrocyte Glycoprotein / immunology*
  • Neuromyelitis Optica / blood
  • Neuromyelitis Optica / diagnosis
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / pathology
  • Optic Neuritis / blood
  • Optic Neuritis / diagnosis
  • Optic Neuritis / immunology
  • Optic Neuritis / pathology
  • Recurrence
  • Retrospective Studies
  • Turkey
  • White Matter / diagnostic imaging
  • White Matter / pathology*

Substances

  • Autoantibodies
  • Immunoglobulin G
  • Myelin-Oligodendrocyte Glycoprotein