[Clinical features of children with myelin oligodendrocyte glycoprotein antibody-associated disorders]
Ping Zheng1, Jian-Zhao Zhang, Jing Sun
1Department of Neurology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China. chenqianxhl@163.com.
Objective:
To study the clinical features and treatment outcome of children with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorders (MOGAD).
Methods:
A retrospective analysis was performed for the clinical data of 28 children with MOGAD (with 38 demyelinating episodes).
Results:
Among the disease spectrums of 28 children with MOGAD, optic neuritis was the most common (12 cases, 43%), followed by acute disseminated encephalomyelitis (9 cases, 32%). Among the 38 demyelinating episodes in the 28 children, there were 29 cases (76%) of lesions in the acute stage on head magnetic resonance imaging (MRI), and most of these lesions were extensive or isolated subcortical white matter lesions. A total of 24 cases of spinal MRI results in the acute stage were recorded, among which there were 11 cases (46%) of spinal lesions. MRI abnormalities of the optic nerve were found in 18 cases of optic neuritis in the acute stage. Of the 28 children, 20 (71%) had an increase in white blood cell count in cerebrospinal fluid, with lymphocytes as the most common type of cells, and 3 children had an increase in protein. The titer of serum MOG antibody was 1:10-1:320 in the 28 children. All 28 children were administered with glucocorticoids, along with immunoglobulin in 18 children. The symptoms of 26 children (93%) were alleviated during follow-up, and only 2 children had neurological sequela of the optic function.
Conclusions:
The clinical manifestations are diverse in children with MOGAD. Immunotherapy is effective and most children have a good prognosis.
Insights
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorders (MOGAD) in children present diverse symptoms, with optic neuritis being most common. Immunotherapy offers effective treatment, leading to good prognoses for most affected children.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Demyelinating Diseases
Background:
- Myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are increasingly recognized inflammatory demyelinating diseases affecting the central nervous system.
- Understanding the clinical spectrum and treatment outcomes in pediatric MOGAD is crucial for effective management.
Purpose of the Study:
- To investigate the clinical features, diagnostic findings, and treatment outcomes of children diagnosed with MOGAD.
- To evaluate the efficacy of immunotherapy in this pediatric population.
Main Methods:
- Retrospective analysis of clinical data from 28 children diagnosed with MOGAD.
- Review of clinical presentations, magnetic resonance imaging (MRI) findings, cerebrospinal fluid (CSF) analysis, and MOG antibody titers.
- Assessment of treatment responses to glucocorticoids and immunoglobulin therapy.
Main Results:
- Optic neuritis (43%) and acute disseminated encephalomyelitis (32%) were the most frequent clinical presentations.
- MRI revealed acute lesions in the brain (76%) and spinal cord (46%), with optic nerve abnormalities in optic neuritis cases.
- Cerebrospinal fluid analysis showed elevated white blood cells in 71% of patients; immunotherapy led to symptom alleviation in 93%.
Conclusions:
- Pediatric MOGAD exhibits diverse clinical manifestations.
- Immunotherapy, including glucocorticoids and immunoglobulin, is an effective treatment strategy.
- The majority of children with MOGAD experience a favorable prognosis with minimal long-term sequelae.
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