1. Children with multiphasic disseminated encephalomyelitis and antibodies to the myelin oligodendrocyte glycoprotein (MOG): Extending the spectrum of MOG antibody positive diseases
- Author
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Romana Höftberger, Barbara Kornek, Heinz Lauffer, Steffen Syrbe, Kevin Rostasy, Rainer Seidl, Iris Marquardt, Katharina Diepold, Michael Karenfort, Markus Reindl, Jurgis Strautmanis, Matthias Baumann, Silvia Vieker, Kathrin Schanda, and Eva-Maria Hennes
- Subjects
Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Demyelinating Autoimmune Diseases, CNS ,Myelin oligodendrocyte glycoprotein ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Child ,Encephalomyelitis ,Autoantibodies ,Neuromyelitis optica ,biology ,business.industry ,Multiple sclerosis ,medicine.disease ,Magnetic Resonance Imaging ,Disseminated encephalomyelitis ,030104 developmental biology ,Neurology ,Child, Preschool ,Recurrent optic neuritis ,Acute disseminated encephalomyelitis ,Immunology ,biology.protein ,Female ,Myelin-Oligodendrocyte Glycoprotein ,Neurology (clinical) ,Antibody ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Background: Myelin oligodendrocyte glycoprotein (MOG) antibodies have been described in children with acute disseminated encephalomyelitis (ADEM), recurrent optic neuritis, neuromyelitis optica spectrum disorders and more recently in children with multiphasic disseminated encephalomyelitis (MDEM). Objective: To delineate the clinical, cerebrospinal fluid (CSF) and radiological features of paediatric MDEM with MOG antibodies. Methods: Clinical course, serum antibodies, CSF, magnetic resonance imaging (MRI) studies and outcome of paediatric MDEM patients were reviewed. Results: A total of 8 children with two or more episodes of ADEM were identified from a cohort of 295 children with acute demyelinating events. All children had persisting MOG antibodies (median titre: 1:1280). All ADEM episodes included encephalopathy, polyfocal neurological signs and a typical MRI. Apart from ADEM episodes, three children had further clinical attacks without encephalopathy. Median age at initial presentation was 3 years (range: 1–7 years) and median follow-up 4 years (range: 1–8 years). New ADEM episodes were associated with new neurological signs and new MRI lesions. Clinical outcome did range from normal (four of the eight) to mild or moderate impairment (four of the eight). A total of four children received monthly immunoglobulin treatment during the disease course. Conclusion: Children with MDEM and persisting MOG antibodies constitute a distinct entity of relapsing demyelinating events and extend the spectrum of MOG antibody–associated diseases.
- Published
- 2016
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