期刊
MULTIPLE SCLEROSIS JOURNAL
卷 28, 期 11, 页码 1697-1709出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/13524585221093789
关键词
All demyelinating diseases (CNS); multiple sclerosis; MRI; autoimmune diseases; all pediatric
资金
- Multiple Sclerosis Scientific Research Foundation
- Clinical Research Training Scholarship in Multiple Sclerosis from the American Academy of Neurology
- NHS National Specialised Commissioning Group for Neuromyelitis Optica, UK
- Waugh Family Chair in Multiple Sclerosis
- National MS Society
- NIH
- Multiple Sclerosis Society of Canada
- Immune Tolerance Network (ITN)
Considering MOGAD as a distinct disease from MS, this study highlights the importance of considering MOG-IgG serology when applying MS diagnostic criteria in children. MOG-IgG seropositivity is associated with atypical features and predicts a non-MS disease course.
Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is now recognized as distinct from multiple sclerosis (MS). Objective: To evaluate the importance of considering myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin-G (IgG) serology when applying MS diagnostic criteria in children. Methods: Within a prospective cohort of children meeting MS criteria (median follow-up = 6 years, interquartile range (IQR) = 4-9), we measured MOG-IgG in serial archived serum obtained from presentation, and compared imaging and clinical features between seropositive and seronegative participants. Results: Of 65 children meeting MS criteria (median age = 14.0 years, IQR = 10.9-15.1), 12 (18%) had MOG-IgG at disease onset. Seropositive participants were younger, had brain magnetic resonance imaging (MRI) features atypical for MS, rarely had cerebrospinal fluid (CSF) oligoclonal bands (2/8, 25%), and accumulated fewer T2 lesions over time. On serial samples, 5/12 (42%) were persistently seropositive, 5/12 (42%) became seronegative, and 2/12 (17%) had fluctuating results. All 12 children experienced a disease course different from typical MS. Conclusion: While children with MOG-IgG can have clinical, CSF, and MRI features conforming to MS criteria, the presence of MOG-IgG is associated with atypical features and predicts a non-MS disease course. Given MOG-IgG seropositivity can wane over time, testing at first attack is of considerable importance for the diagnosis of MOGAD.
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