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Broad Clinical Spectrum Linked to Pediatric MOG Antibodies

Presenting syndromes include ADEM, encephalitis other than ADEM, optic neuritis, myelitis

TUESDAY, Feb. 11, 2020 (HealthDay News) — The spectrum of pediatric syndromes associated with myelin oligodendrocyte glycoprotein (MOG) antibodies is wider than previously thought, according to a study published online Feb. 10 in The Lancet Neurology.

Thaís Armangue, M.D., from the Universitat de Barcelona in Spain, and colleagues conducted a prospective observational study involving children with demyelinating syndromes and with encephalitis other than acute disseminated encephalomyelitis (ADEM) who were investigated for MOG antibodies. A total of 239 children with demyelinating syndromes (cohort A) and 296 with encephalitis other than ADEM (cohort B) were recruited.

The researchers found that 116 patients had MOG antibodies, including 39 and 7 percent from cohorts A and B, respectively. In these 116 patients, presenting syndromes included ADEM, encephalitis other than ADEM, optic neuritis, myelitis, neuromyelitis optica spectrum disorders, and other disorders (68, 19, 17, 11, 5, and 8 percent, respectively). MOG antibodies were more common than all neuronal antibodies combined among the patients with autoimmune encephalitis in cohort B (34 versus 33 percent). Twenty-eight percent of the patients had relapses after a median follow-up of 42 months, including 17 percent of 100 diagnosed at the first episode. Eighty-five percent of the 116 patients had substantial recovery; 15 percent had moderate-to-severe deficits (one patient died).

“In view of the very broad clinical spectrum now associated with MOG autoimmunity, the next challenge will be to identify the optimal therapeutic strategy for each clinical presentation,” writes the author of an accompanying editorial.

Several authors disclosed financial ties to the biopharmaceutical industry.

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