Attack phenotypes and disease course in pediatric MOGAD.

Area of Science:

• Neuroimmunology
• Pediatric Neurology
• Demyelinating Diseases

Background:

• Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disorder targeting the central nervous system.
• Pediatric MOGAD exhibits distinct clinical characteristics compared to adult presentations.

Purpose of the Study:

• To review the literature on the presentation and clinical course of MOGAD specifically in children.
• To identify common initial phenotypes and relapse patterns in pediatric MOGAD.

Main Methods:

• A comprehensive literature review was conducted.
• Studies focusing on pediatric MOGAD cases were analyzed for clinical presentation and disease course.

Main Results:

• The most frequent initial presentation in children, particularly those under five, is acute disseminated encephalomyelitis.
• Optic neuritis and/or transverse myelitis are also common initial or subsequent manifestations.
• Approximately 25% of pediatric patients experience at least one relapse within three years, often involving optic neuritis.

Conclusions:

• Pediatric MOGAD has a varied presentation, with acute disseminated encephalomyelitis being prominent in younger children.
• Relapses are common in pediatric MOGAD, highlighting the need for long-term monitoring.
• Further research is needed to identify clinical risk factors for a relapsing disease course in children.