MOG encephalomyelitis: distinct clinical, MRI and CSF features in patients with longitudinal extensive transverse myelitis as first clinical presentation.

Abstract

BACKGROUND:

Based on clinical, immunological and histopathological evidence, MOG-IgG-associated encephalomyelitis (MOG-EM) has emerged as a distinct disease entity different from multiple sclerosis (MS) and aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder (NMOSD). MOG-EM is associated with a broader clinical phenotype including optic neuritis, myelitis, brainstem lesions and acute disseminated encephalomyelitis with a substantial clinical and radiological overlap to other demyelinating CNS disorders.

OBJECTIVE:

To evaluate common clinical, MRI and CSF findings, as well as therapy responses in patients with longitudinal extensive transverse myelitis (LETM) as initial clinical presentation of MOG-EM.

METHODS:

After excluding patients with a known diagnosis of MS, we identified 153 patients with myelitis of which 7 fulfilled the inclusion criteria and were investigated for MRI, CSF and clinical parameters.

RESULTS:

Patients with LETM as first clinical presentation of MOG-EM display similar characteristics, namely a lack of gadolinium-enhancement in spinal cord MRI, marked pleocytosis, negative oligoclonal bands, a previous history of infections/vaccinations and response to antibody-depleting treatments for acute attacks and long-term treatment.

CONCLUSIONS:

We identify common pathological findings in patients with LETM as first clinical presentation of MOG-EM which distinguishes it from other forms of LETM and should lead to testing for MOG-IgG in these cases.

• Authors: Julia Loos, Steffen Pfeuffer, Katrin Pape, Tobias Ruck, Felix Luessi, Annette Spreer, Frauke Zipp, Sven G Meuth, Stefan Bittner
• Journal: Journal of neurology (J Neurol) Vol. 267 Issue 6 Pg. 1632-1642 (Jun 2020) ISSN: 1432-1459 [Electronic] Germany
• PMID: 32055995 (Publication Type: Journal Article)

Chemical References

• Autoantibodies
• MOG protein, human
• Myelin-Oligodendrocyte Glycoprotein

Topics

• Adult
• Autoantibodies (blood)
• Demyelinating Autoimmune Diseases, CNS (blood, cerebrospinal fluid, diagnosis, immunology)
• Encephalomyelitis (blood, cerebrospinal fluid, diagnostic imaging, immunology)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Myelin-Oligodendrocyte Glycoprotein (immunology)
• Myelitis, Transverse (blood, cerebrospinal fluid, diagnostic imaging, immunology)
• Retrospective Studies
• Young Adult