Different features between pediatric-onset and adult-onset patients who are seropositive for MOG-IgG: A multicenter study in South China

作者：Chen, Lu; Chen, Chen; Zhong, Xiaonan; Sun, Xiaobo; Zhu, Haixia; Li, Xiaojing; Yang, Hui; Shu, Yaqing; Chang, Yanyu; Hu, Xueqiang; Lu, Zhengqi; Peng, Lisheng^*; Qiu, Wei^*

来源：Journal of Neuroimmunology, 2018, 321: 83-91.

DOI：10.1016/j.jneuroim.2018.05.014

• MOG-IgG
• Pediatric-onset
• Adult-onset
• Demyelinating disease

Background: Immunoglobulin against myelin oligodendrocyte glycoprotein (MOG-IgG) is a potential demyelinating disease-associated autoantibody. Whether clinical features of MOG antibody-associated demyelinating diseases change with age remains unclear. @@@ Object: To investigate the different clinical features between pediatric-onset and adult-onset MOG-IgG-seropositive patients in a relatively large cohort. @@@ Methods: A total of 816 consecutive patients with suspected demyelinating disease were prospectively enrolled from three tertiary academic centers in South China from February 2016 to December 2016. Sixteen pediatric-onset cases ( <= 14 years old) and 34 adult-onset cases (> 14 years old) seropositive for MOG-IgG were identified. Differences in clinical features between the two groups were investigated. @@@ Results: There was a significant difference in the cumulative incidence of first relapse among the two groups (P = .008). Cerebral symptoms were significantly higher in pediatric-onset patients than in adult-onset patients, either at disease onset (pediatric-onset group, 10/16(62.5%); adult-onset group, 8/34(23.53%); P = .007) or throughout the course of disease (pediatric-onset group, 11/16(68.8%); adult-onset group, 10/34(29.4%); P = .009). Optic nerve symptoms were more common in adult-onset groups, but no significant difference was found between the two groups. A significantly higher rate of pediatric-onset patients (9/16, 56.3%) met the acute disseminated encephalomyelitis criteria compared with adult-onset patients (2/34, 5.9%) (P = .0003), and isolated optic neuritis was mainly diagnosed in adult-onset patients (pediatric-onset group, 2/16(12.5%); adult-onset group, 14/34(41.2%); P = .043). The MOG-IgG titer showed a significant positive correlation with total protein levels in cerebrospinal fluid, but only in adult-onset patients (r = 0.95; P = .0004). On magnetic resonance imaging, extensive white matter lesions were observed in both groups, and the number was much higher in pediatric-onset (7/15, 46.7%) than in adult-onset patients (4/29, 13.8%) (P = .043). At the last follow-up, more pediatric-onset patients (10/16, 62.5%) experienced complete recovery (EDSS 0.0 at last follow up) compared with adult-onset patients (9/34, 26.5%) (P = .014). @@@ Conclusions: Distinctive features are present between pediatric-onset and adult-onset patients with MOG-IgG. Further studies are required to determine the different underlying pathogenesis of MOG antibody at different ages.

• 出版日期2018-8-15
• 单位中山大学; 广州市妇女儿童医疗中心