Clinical and MRI phenotype of children with MOG antibodies.

Abstract

OBJECTIVE:

To investigate the clinical and magnetic resonance imaging (MRI) features of anti-myelin oligodendrocyte glycoprotein (MOG) antibody-seropositive pediatric demyelinating syndromes.

METHODS:

Serum samples collected from 74 children with suspected demyelinating disorders whom were being followed at Massachusetts General Hospital were incubated with control green fluorescent protein (GFP)- and MOG-GFP-transfected Jurkat cell clones. The binding ratios were calculated using flow cytometry. Using statistical analyses, we compared the demographic, clinical and radiological features in our seropositive and seronegative patients.

RESULTS:

We found that 13 out of 74 (17.5%) patients were seropositive for MOG. The MOG-seropositive patients were younger than the seronegative patients (p = 0.049). No single disease category predominated among the seropositive patients, nor was one group more likely to have a polyphasic course. There were two out of four neuromyelitis optica (NMO) patients who had MOG antibodies; both were seronegative for aquaporin -4 (AQP4) antibodies. One had monophasic disease and the other had frequent relapses. There was a bimodal distribution of the MOG-seropositive patients by age at onset, with a distinct younger group (4-8 years) having a high prevalence of encephalopathy and an older group (13-18 years), whom presented almost exclusively with optic neuritis. MRI analysis demonstrated the absence of corpus callosum lesions in the seropositive patients (p = 0.012). The annualized relapse rate (ARR) and the Expanded Disability Status Scale (EDSS) results at 2 years did not differ between the seropositive and seronegative patients.

CONCLUSION:

MOG antibodies are found across a variety of pediatric demyelinating syndromes having some distinct clinical and MRI features.

• Authors: Cristina Fernandez-Carbonell, David Vargas-Lowy, Alexander Musallam, Brian Healy, Katherine McLaughlin, Kai W Wucherpfennig, Tanuja Chitnis
• Journal: Multiple sclerosis (Houndmills, Basingstoke, England) (Mult Scler) Vol. 22 Issue 2 Pg. 174-84 (Feb 2016) ISSN: 1477-0970 [Electronic] England
• PMID: 26041801 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s), 2015.

Chemical References

• AQP4 protein, human
• Aquaporin 4
• Autoantibodies
• MOG protein, human
• Myelin-Oligodendrocyte Glycoprotein

Topics

• Adolescent
• Aquaporin 4 (immunology)
• Autoantibodies (immunology)
• Brain (pathology)
• Child
• Demyelinating Autoimmune Diseases, CNS (immunology, pathology, physiopathology)
• Demyelinating Diseases (immunology, pathology, physiopathology)
• Encephalomyelitis, Acute Disseminated (immunology)
• Female
• Flow Cytometry
• Humans
• Magnetic Resonance Imaging
• Male
• Multiple Sclerosis (immunology, pathology, physiopathology)
• Myelin-Oligodendrocyte Glycoprotein (immunology)
• Neuromyelitis Optica (immunology, pathology, physiopathology)
• Optic Neuritis (immunology, pathology, physiopathology)
• Phenotype
• Spinal Cord (pathology)