Prognostic Relevance of Mog Antibodies in Children With an Acquired Demyelinating Syndrome
Tarih
2017Yazar
Hennes, Eva-Maria
Baumann, Matthias
Schanda, Kathrin
Anlar, Banu
Bajer-Kornek, Barbara
Blaschek, Astrid
Brantner-Inthaler, Sigrid
Diepold, Katharina
Eisenkolbl, Astrid
Gotwald, Thaddaeus
Kuchukhidze, Georgi
Gruber-Sedlmayr, Ursula
Haeusler, Martin
Hoeftberger, 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
Rostasy, Kevin
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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. Thirtyfive 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.