#Anti mog antibody serial#
On serial serum analysis, 38 of 67 participants (57%) who were seropositive at onset became seronegative (median time to conversion, 1 year). Complete resolution of baseline lesions was observed in 26 of 49 anti-MOG antibody–positive participants (53%). Brain lesions were present in 51 of 76 anti-MOG antibody–positive participants (67%), but magnetic resonance imaging characteristics differed with age at presentation. Clinical presentations included a combination of optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis for 81 of 84 anti-MOG antibody–positive children (96%). One-third of children were positive for anti-MOG antibodies at the time of incident demyelination. Results Of the 274 included participants, 140 (51.1%) were female, and the median (interquartile range) age of all participants was 10.8 (6.2-13.9) years. Clinical, magnetic resonance imaging, and cerebrospinal fluid features were characterized at presentation, and subsequent disease course was assessed by development of new brain magnetic resonance imaging lesions, total lesion volume at last evaluation, annualized relapse rates, Expanded Disability Status Scale score and visual functional score at 4 years, and any disease-modifying treatment exposure. Main Outcomes and Measures Presence of anti-MOG antibodies was blindly assessed in serial samples collected over a median of 4 years.
Data were analyzed from May to October 2018. Of 156 excluded participants, 154 were excluded owing to missing baseline samples and 2 owing to incomplete clinical information. Of 430 participants with acquired demyelinating syndrome recruited, 274 were included in analyses. Inclusion criteria included (1) incident central nervous system demyelination, (2) at least 1 serum sample obtained within 45 days from onset, and (3) complete clinical information. Objective To characterize serial anti-MOG antibody serologies and clinical and imaging features at presentation and during follow-up in an inception cohort of prospectively monitored children with acquired demyelination.ĭesign, Setting, and Participants In this prospective cohort study, study participants were recruited from July 2004 to February 2017 through the multicenter Canadian Pediatric Demyelinating Disease Study. Importance Identifying the course of demyelinating disease associated with myelin oligodendrocyte glycoprotein (MOG) autoantibodies is critical to guide appropriate treatment choices. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.The data points indicate the titers measured at each serological evaluation. D and E, Trajectory of serial MOG titers of anti-MOG antibody–positive participants with ADEM at onset (D) and without ADEM at onset (E).
Participants with ADEM had a considerably shorter time to seroconversion than participants without ADEM. C, Kaplan-Meier curves in participants with acute disseminated encephalomyelitis (ADEM) vs non-ADEM presentations. B, Kaplan-Meier curve for the time to conversion to seronegative status in all participants who were positive for anti-MOG antibodies at time of presentation.
Of the 10 participants with borderline results at onset, 7 became seronegative, 2 fluctuated between negative and borderline status and 1 became seropositive in the last follow-up sample (7 years from onset titer, 1:200). Only 2 of 139 participants who were negative for anti-MOG antibodies at presentation changed serological status in subsequent examinations: 1 participant became seropositive at 3 months and was persistently positive for the subsequent 8 years and 1 had an isolated finding of a borderline result at 2 years from onset. A, Evolution of serologic status in participants with follow-up greater than 1 year.
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