Prognostic relevance of MOG antibodies in children with an acquired demyelinating syndrome. (29th August 2017)

• Record Type: Journal Article
• Authors: Hennes, Eva-Maria; Baumann, Matthias; Schanda, Kathrin; Anlar, Banu; Bajer-Kornek, Barbara; Blaschek, Astrid; Brantner-Inthaler, Sigrid; Diepold, Katharina; Eisenkölbl, Astrid; Gotwald, Thaddäus; Kuchukhidze, Georgi; Gruber-Sedlmayr, Ursula; Häusler, Martin; Höftberger, Romana; Karenfort, Michael; Klein, Andrea; Koch, Johannes; Kraus, Verena; Lechner, Christian; Leiz, Steffen; Leypoldt, Frank; Mader, Simone; Marquard, Klaus; Poggenburg, Imke; Pohl, Daniela; Pritsch, Martin; Raucherzauner, Markus; Schimmel, Mareike; Thiels, Charlotte; Tibussek, Daniel; Vieker, Silvia; Zeches, Carolin; Berger, Thomas; Reindl, Markus; Rostásy, Kevin;
• Is Part Of: Neurology. Volume 89:Number 9(2017)
• Publication Date: 2017-08-29
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000004312
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To assess the prognostic value of MOG antibodies (abs) in the differential diagnosis of acquired demyelinating syndromes (ADS). Methods: Clinical course, MRI, MOG-abs, AQP4-abs, and CSF cells and oligoclonal bands (OCB) in children with ADS and 24 months of follow-up were reviewed in this observational prospective multicenter hospital-based study. Results: Two hundred ten children with ADS were included and diagnosed with acute disseminated encephalomyelitis (ADEM) (n = 60), neuromyelitis optica spectrum disorder (NMOSD) (n = 12), clinically isolated syndrome (CIS) (n = 101), and multiple sclerosis (MS) (n = 37) after the first episode. MOG-abs were predominantly found in ADEM (57%) and less frequently in NMOSD (25%), CIS (25%), or MS (8%). Increased MOG-ab titers were associated with younger age ( p = 0.0001), diagnosis of ADEM ( p = 0.005), increased CSF cell counts ( p = 0.011), and negative OCB ( p = 0.012). At 24-month follow-up, 96 children had no further relapses. Thirty-five children developed recurrent non-MS episodes (63% MOG-, 17% AQP4-abs at onset). Seventy-nine children developed MS (4% MOG-abs at onset). Recurrent non-MS episodes were associated with high MOG-ab titers ( p = 0.0003) and older age at onset ( p = 0.024). MS was predicted by MS-like MRI ( p < 0.0001) and OCB ( p = 0.007). An MOG-ab cutoff titer ≥1:1, 280 predicted a non-MS course with a sensitivity of 47% and a specificity of 100% and a recurrent non-MS course with a sensitivity of 46% and a specificity of 86%. Conclusions: Our results show that the presence of MOG-abs strongly depends on the age at disease onset and that high MOG-ab titers were associated with a recurrent non-MS disease course.