Myelitis in inflammatory disorders associated with myelin oligodendrocyte glycoprotein antibody and aquaporin-4 antibody: A comparative study in Chinese Han patients.

Abstract

BACKGROUND AND PURPOSE:

Myelitis is an important clinical component of myelin oligodendrocyte glycoprotein antibody (MOG-ab)-associated disease (MOGAD) and aquaporin-4 antibody (AQP4-ab)-positive neuromyelitis optica spectrum disorder (NMOSD). The aim of this work was to evaluate the differentiating features of myelitis between the two diseases.

METHODS:

Myelitis-related clinical and radiologic data from 130 patients with MOGAD and 125 patients with AQP4-ab-positive NMOSD were retrospectively reviewed and compared. A scoring model was established to differentiate MOG-ab-associated myelitis from AQP4-ab-associated myelitis.

RESULTS:

Overall, 29.2% (38/130) of patients with MOGAD and 66.4% (83/125) of patients with AQP4-ab-positive NMOSD had ever experienced myelitis. Compared with those with NMOSD, patients with MOGAD exhibited a lower frequency of myelitis, either during the first episode (p < 0.0001) or throughout the disease duration (p < 0.0001). Compared with AQP4-ab-associated myelitis, MOG-ab-associated myelitis manifested a higher male-to-female ratio (p < 0.0001), younger age at disease onset (p = 0.0004), more prodromic influenza-like symptoms (p = 0.030), more prodromic fever (p = 0.0003), more bowel and bladder dysfunction (p = 0.011), less painful tonic spasms (p < 0.0001), and lower Expanded Disability Status Scale scores after treatment (p < 0.0001). On magnetic resonance imaging, lower spinal cord lesions (p = 0.023), short-segment lesions (p = 0.021), conus involvement (p = 0.0001), and H sign (p < 0.0001) were more common in MOG-ab-associated myelitis. A scoring model with a cutoff value of 4 differentiated MOG-ab-associated myelitis from AQP4-ab-associated myelitis with a sensitivity of 87.9% and a specificity of 90.1%.

CONCLUSIONS:

Myelitis was less commonly observed in MOGAD and exhibited distinct features compared to those of AQP4-ab-positive NMOSD.

• Authors: Jingzi ZhangBao, Wenjuan Huang, Lei Zhou, Liang Wang, Xuechun Chang, Chuanzhen Lu, Chongbo Zhao, Jiahong Lu, Chao Quan
• Journal: European journal of neurology (Eur J Neurol) Vol. 28 Issue 4 Pg. 1308-1315 (04 2021) ISSN: 1468-1331 [Electronic] England
• PMID: 33220172 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 European Academy of Neurology.

Chemical References

• Aquaporin 4
• Autoantibodies
• Myelin-Oligodendrocyte Glycoprotein

Topics

• Aquaporin 4
• Autoantibodies
• China
• Female
• Humans
• Male
• Myelin-Oligodendrocyte Glycoprotein
• Myelitis
• Neuromyelitis Optica (diagnostic imaging)
• Retrospective Studies