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

被引:175
作者
Hacohen, Yael [1 ]
Absoud, Michael [2 ]
Deiva, Kumaran [3 ,4 ,5 ]
Hemingway, Cheryl [6 ]
Nytrova, Petra [7 ,8 ,9 ]
Woodhall, Mark [1 ]
Palace, Jacqueline [1 ]
Wassmer, Evangeline [10 ]
Tardieu, Marc [3 ,4 ,5 ]
Vincent, Angela [1 ]
Lim, Ming [1 ,2 ]
Waters, Patrick [1 ]
机构
[1] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Clin Neurosci, Oxford, England
[2] Kings Hlth Partners Acad Hlth Sci Ctr, Evelina Childrens Hosp Guys & St Thomas NHS Fdn T, Childrens Neurosci, London, England
[3] Hop Univ Paris Sud, Assistance Publ Hop Paris, Paris, France
[4] Univ Paris Sud, Kremlin Bicetre, Pediat Neurol Dept, Paris, France
[5] Univ Paris Sud, Kremlin Bicetre, Natl Referral Ctr Neuroinflammatory Dis, Paris, France
[6] Great Ormond St Hosp Sick Children, Dept Paediat Neurol, London, England
[7] Gen Univ Hosp Prague, Dept Neurol, Prague, Czech Republic
[8] Gen Univ Hosp Prague, Ctr Clin Neurosci, Prague, Czech Republic
[9] Charles Univ Prague, Fac Med 1, Prague, Czech Republic
[10] Birmingham Childrens Hosp, Dept Paediat Neurol, Birmingham, W Midlands, England
关键词
D O I
10.1212/NXI.0000000000000081
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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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