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Hennes, EM; Baumann, M; Schanda, K; Anlar, B; Bajer-Kornek, B; Blaschek, A; Brantner-Inthaler, S; Diepold, K; Eisenkölbl, A; Gotwald, T; Kuchukhidze, G; Gruber-Sedlmayr, U; Häusler, M; Höftberger, R; Karenfort, M; Klein, A; Koch, J; Kraus, V; Lechner, C; Leiz, S; Leypoldt, F; Mader, S; Marquard, K; Poggenburg, I; Pohl, D; Pritsch, M; Raucherzauner, M; Schimmel, M; Thiels, C; Tibussek, D; Vieker, S; Zeches, C; Berger, T; Reindl, M; Rostásy, K; BIOMARKER Study Group.
Prognostic relevance of MOG antibodies in children with an acquired demyelinating syndrome.
Neurology. 2017; 89(9):900-908
Web of Science PubMed FullText FullText_MUG

 

Authors Med Uni Graz:
Gruber-Sedlmayr Ursula
Haeusler Martin
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Abstract:
To assess the prognostic value of MOG antibodies (abs) in the differential diagnosis of acquired demyelinating syndromes (ADS). 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. 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. Thirty-five 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%. 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. © 2017 American Academy of Neurology.
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