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Neurol Neuroimmunol Neuroinflamm. 2015 Mar 12;2(2):e81. doi: 10.1212/NXI.0000000000000081. eCollection 2015 Apr.

Myelin oligodendrocyte glycoprotein antibodies are associated with a non-MS course in children.

Author information

1
Nuffield Department of Clinical Neurosciences (Y.H., M.W., J.P., A.V., M.L., P.W.), John Radcliffe Hospital, University of Oxford, UK; Children's Neurosciences (M.A., M.L.), Evelina Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London, UK; Assistance Publique Hôpitaux de Paris (K.D., M.T.), Hopitaux Universitaires Paris Sud, France; Pediatric Neurology Department and National Referral Center for Neuroinflammatory Diseases (K.D., M.T.), Université Paris Sud, Le Kremlin-Bicêtre, Paris, France; Department of Paediatric Neurology (C.H.), Great Ormond Street Hospital for Children, London, UK; Department of Neurology and Center of Clinical Neuroscience (P.N.), General University Hospital in Prague, Czech Republic; First Faculty of Medicine (P.N.), Charles University in Prague, Czech Republic; and Department of Paediatric Neurology (E.W.), Birmingham Children's Hospital, UK.

Abstract

OBJECTIVE:

To determine whether myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) were predictive of a demyelination phenotype in children presenting with acquired demyelinating syndrome (ADS).

METHOD:

Sixty-five children with a first episode of ADS (12 acute disseminated encephalomyelitis, 24 optic neuritis, 18 transverse myelitis, 11 other clinically isolated syndrome) were identified from 2 national demyelination programs in the United Kingdom and France. Acute serum samples were tested for MOG-Abs by cell-based assay. Antibodies were used to predict diagnosis of multiple sclerosis (MS) at 1 year.

RESULTS:

Twenty-three of 65 (35%) children had MOG-Abs. Antibody-positive and antibody-negative patients were not clinically different at presentation, but identification of MOG-Abs predicted a non-MS course at 1-year follow-up: only 2/23 (9%) MOG-Ab-positive patients were diagnosed with MS compared to 16/42 (38%) MOG-Ab-negative patients (p = 0.019, Fisher exact test). Antibody positivity at outset was a useful predictor for a non-MS disease course, with a positive predictive value of 91% (95% confidence interval [CI] 72-99), negative predictive value of 38% (95% CI 24-54), positive likelihood ratio of 4.02 (CI 1.0-15.4), and odds ratio of 6.5 (CI 1.3-31.3).

CONCLUSIONS:

MOG-Abs are found at presentation in 35% of patients with childhood ADS, across a range of demyelinating disorders. Antibody positivity can be useful in predicting a non-MS disease course at onset.

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