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J Neurol Neurosurg Psychiatry. 2016 Aug;87(8):897-905. doi: 10.1136/jnnp-2015-311743. Epub 2015 Dec 8.

Antibodies to MOG and AQP4 in children with neuromyelitis optica and limited forms of the disease.

Author information

1
Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.
2
Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany.
3
Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
4
Department of Pediatric Neurology, University Children's Hospital Dusseldorf, Dusseldorf, Germany.
5
Department of Pediatric Neurology, Children's Hospital Dritter Orden, Munich, Germany.
6
Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Canada.
7
Department of Pediatric Neurology, DRK Children's Hospital Siegen, Siegen, Germany.
8
Department of Pediatrics, Paracelsus Medical University Salzburg, Salzburg, Austria.
9
Department of Pediatric Neurology, Children's Hospital Augsburg, Augsburg, Germany.
10
Division of Neuropediatrics and Social Pediatrics, University Hospital, RWTH Aachen, Aachen, Germany.
11
Department of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland.
12
Department of Pediatric Neurology and Developmental Medicine, Dr von Hauner's Children's Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
13
Department of Pediatric Neurology with Social Pediatrics, Children's Hospital, Ruhr University Bochum, Bochum, Germany.
14
Department of Pediatrics, Medical University of Graz, Graz, Austria.
15
Department of Neurology, Medical University of Vienna, Vienna, Austria.
16
Department of Pediatric Neurology, University Children's Hospital Giessen, Giessen, Germany.
17
Department of Neuroimmunology, Institute of Clinical Chemistry, Kiel, Germany Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany.
18
Department of Pediatric Neurology, Children's Hospital Koblenz, Koblenz, Germany.
19
Department of Pediatric Neurology, Children's Hospital Memmingen, Memmingen, Germany.
20
Department of Pediatric Neurology, Children's Hospital Neuburg, Neuburg, Germany.
21
Department of Pediatric Neurology, University Children's Hospital Oldenburg, Oldenburg, Germany.
22
Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany.

Abstract

OBJECTIVE:

To determine the frequency and clinical-radiological associations of antibodies to myelin oligodendrocyte glycoprotein (MOG) and aquaporin-4 (AQP4) in children presenting with neuromyelitis optica (NMO) and limited forms.

METHODS:

Children with a first event of NMO, recurrent (RON), bilateral ON (BON), longitudinally extensive transverse myelitis (LETM) or brainstem syndrome (BS) with a clinical follow-up of more than 12 months were enrolled. Serum samples were tested for MOG- and AQP4-antibodies using live cell-based assays.

RESULTS:

45 children with NMO (n=12), LETM (n=14), BON (n=6), RON (n=12) and BS (n=1) were included. 25/45 (56%) children had MOG-antibodies at initial presentation (7 NMO, 4 BON, 8 ON, 6 LETM). 5/45 (11%) children showed AQP4-antibodies (3 NMO, 1 LETM, 1 BS) and 15/45 (33%) were seronegative for both antibodies (2 NMO, 2 BON, 4 RON, 7 LETM). No differences were found in the age at presentation, sex ratio, frequency of oligoclonal bands or median EDSS at last follow-up between the three groups. Children with MOG-antibodies more frequently (1) had a monophasic course (p=0.018) after one year, (2) presented with simultaneous ON and LETM (p=0.004) and (3) were less likely to receive immunosuppressive therapies (p=0.0002). MRI in MOG-antibody positive patients (4) less frequently demonstrated periependymal lesions (p=0.001), (5) more often were unspecific (p=0.004) and (6) resolved more frequently (p=0.016).

CONCLUSIONS:

67% of all children presenting with NMO or limited forms tested positive for MOG- or AQP4-antibodies. MOG-antibody positivity was associated with distinct features. We therefore recommend to measure both antibodies in children with demyelinating syndromes.

PMID:
26645082
DOI:
10.1136/jnnp-2015-311743
[Indexed for MEDLINE]
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