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Ann Neurol. 2015 Jun;77(6):1076-82. doi: 10.1002/ana.24409. Epub 2015 May 11.

Oligoclonal bands predict multiple sclerosis in children with optic neuritis.

Author information

1
Children's Hospital Aschaffenburg, Aschaffenburg, Germany.
2
Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, United Kingdom.
3
Department of Neuropaediatrics, Developmental Neurology and Social Paediatrics, University Children's Hospital Tübingen, Tübingen, Germany.
4
HELIOS Children's Hospital Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.
5
Department of Paediatrics, University of Rostock, Rostock, Germany.
6
Department of Neuropediatrics and Muscular Disorders, Center of Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany.
7
Department of Child Neurology, Center of Paediatrics, University Hospital Frankfurt/Main, Frankfurt am Main, Germany.
8
Department of Neuropediatrics, University Children's Hospital of Saarland, Homburg, Germany.
9
Department of Neurology, University of Würzburg, Würzburg, Germany.
10
Department of Neurology, Medical University of Vienna, Vienna, Austria.
11
Department of Pediatrics, University of Cologne, Cologne, Germany.
12
Children's Hospital Augsburg, Augsburg, Germany.
13
Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
14
Department of Pediatrics, Division of Neuropediatrics and Social Pediatrics, University Hospital RWTH Aachen, Aachen, Germany.
15
Department of Neuropediatrics, Developmental Neurology, and Social Pediatrics, University of Essen, Essen, Germany.
16
Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital Düsseldorf, Düsseldorf, Germany.
17
Department of Paediatric Neurology and Developmental Medicine, Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany.
18
Department of Pediatric Neurology, Technical University Dresden, Dresden, Germany.
19
University Hospital for Pediatric and Adolescent Medicine, Department of Pediatric Neurology, Heidelberg, Germany.
20
Department for Neuropediatrics, Children's and Youth Hospital "Auf der Bult", Hannover, Germany.
21
Division of Pediatric Neurology, Department of Pediatrics I, Innsbruck Medical University, Innsbruck, Austria and Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany.
22
Department of Neuropediatrics, University Children's Hospital, Ruhr University Bochum, Bochum, Germany.
23
Division of Neuropediatrics and Developmental Medicine, University Children's Hospital Basel, Basel, Switzerland.
24
Department of Pediatrics, Division of Neuropediatrics, University of Erlangen-Nürnberg, Erlangen, Germany.
25
University Children's Hospital Würzburg, Würzburg, Germany.
26
Department of Pediatric Neurology, Justus Liebig University Giessen, Giessen, Germany.
27
Department of Neurology, University of Regensburg, Regensburg, Germany.
28
Department of Neuropediatrics, Children's Hospital of the University of Leipzig, Leipzig, Germany.

Abstract

We retrospectively evaluated predictors of conversion to multiple sclerosis (MS) in 357 children with isolated optic neuritis (ON) as a first demyelinating event who had a median follow-up of 4.0 years. Multiple Cox proportional-hazards regressions revealed abnormal cranial magnet resonance imaging (cMRI; hazard ratio [HR] = 5.94, 95% confidence interval [CI] = 3.39-10.39, p < 0.001), presence of cerebrospinal fluid immunoglobulin G oligoclonal bands (OCB; HR = 3.69, 95% CI = 2.32-5.86, p < 0.001), and age (HR = 1.08 per year of age, 95% CI = 1.02-1.13, p = 0.003) as independent predictors of conversion, whereas sex and laterality (unilateral vs bilateral) had no influence. Combined cMRI and OCB positivity indicated a 26.84-fold higher HR for developing MS compared to double negativity (95% CI = 12.26-58.74, p < 0.001). Accordingly, cerebrospinal fluid analysis may supplement cMRI to determine the risk of MS in children with isolated ON.

PMID:
25820181
DOI:
10.1002/ana.24409
[Indexed for MEDLINE]

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