Last modified: 2014-04-03
Abstract
Objectives:
Anti-myelin oligodendrocyte glycoprotein (anti-MOG) antibodies have been identified in paediatric acute demyelinating encephalomyelitis (ADEM). Their relevance remains uncertain.
We aimed to define the features of cases with anti-MOG antibody in our paediatric population.
Materials and Methods:
Case series of paediatric patients with monophasic or recurrent demyelinating episodes who demonstrated anti-MOG antibodies in serum.
Results:
We describe five children with serum anti-MOG antibodies; three females, two male. All cases were serum aquaporin-4 antibody negative. Mean follow-up was 9.8 months (1-30). Mean age at onset was 6 years (5-7). Every case presented with ADEM, monophasic in four cases. In one, unilateral optic neuritis (ON) developed 8 weeks later and ON subsequently recurred after three months. Neuroimaging was typical for ADEM in all cases, although initial scans were normal in three cases. Two cases had spinal cord lesions. All had cerebrospinal fluid (CSF) pleocytosis, with marked lymphocytosis in two cases, and one had markedly elevated protein. Each case received intravenous steroids at diagnosis, followed by reducing doses of oral steroid.
Conclusions:
In this case series, anti-MOG antibody positivity was associated with monophasic ADEM in all but one case, in which there was also recurrent optic neuritis. Each child made a full recovery, suggesting that presence of the antibody does not necessarily confer a poor short-term prognosis. Although anti-MOG antibody is a useful marker for autoimmune aetiology, it is yet to be seen if this predicts recurrence or risk of multiple sclerosis in the longer term.