![]() Thirty-five patients were included in the MOG-IgG-positive group, and the remaining 50 MOG-IgG-negative patients were included in the MOG-IgG-negative group.Īll demographic, clinical, laboratory, and MRI data were collected from all patients. After excluding two patients who were followed up for less than three months, a total of 85 ADEM patients who underwent serum MOG-IgG testing were finally included in our cohort (Fig. The exclusion criteria were (1) less than 3 months of follow-up and (2) other intracranial infectious diseases or systemic autoimmune diseases. The diagnostic criteria of ADEM were in line with the 2013 International Pediatric Multiple Sclerosis Study Group criteria for pediatric ADEM, including all of the following: (1) the first multifocal CNS event (probably caused by inflammatory demyelination) (2) symptoms of encephalopathy (disorder of consciousness or behavioral changes) that could not be explained by fever (3) no new clinical or lesions revealed by MRI 3 months after onset (4) abnormal head MRI in the acute stage (within 3 months) and (5) typical findings in head MRI. According to the serum MOG antibody level, the patients were divided into two groups: MOG-IgG-positive and MOG-IgG-negative. The MOG antibody in the serum was determined using CBAs (cell-based assays) on the first day of hospitalization, and the levels of ≥1:10 were classified as positive. All pediatric patients provided informed consent. The study was approved by the Ethics Committee of the Children’s Hospital of Zhejiang University School of Medicine, China (2019-IRB-115). This study retrospectively compared the clinical characteristics and prognosis of ADEM children with and without MOG antibody to improve the diagnosis and treatment of MOG-IgG-positive ADEM and to identify the factors associated with this disease.Ī retrospective study was conducted in the Department of Neurology, Children’s Hospital of Zhejiang University School of Medicine, China, and included pediatric ADEM patients who underwent serum MOG antibody detection from May 2017 to August 2020. So far, the pathological mechanism and risk factors for anti-MOG antibody-positive ADEM are still not well established. Most children with ADEM have a good prognosis, and a few may have recurrence and residual sequelae. ADEM is an immune-mediated demyelinating CNS disease, manifested as encephalopathy, polyfocal neurologic symptoms, and multifocal demyelinating lesions in the brain and spinal cord. The first episode of MOGADs in children involves acute disseminated encephalomyelitis (ADEM) and optic neuritis (ON), and ADEM is particularly common in young children. MOG-immunoglobulin G (IgG)-associated disorders (MOGADs) have a variety of clinical phenotypes and have been the focus of neurology research in recent years. Myelin oligodendrocyte glycoprotein (MOG) antibody, expressed in the outermost layer of the myelin sheaths in the mammalian central nervous system (CNS), mediates a variety of demyelinating diseases. Our findings provide clinical evidence that MOG-IgG positivity is associated with longer disease duration, meningeal involvement, and frontal lobe involvement. Multivariate logistic regression analysis showed that the longer disease duration, meningeal involvement and frontal lobe involvement were the correlated factors of patients with ADEM with MOG antibody ( P < 0.05). 2%), lower serum tumor necrosis factor (1–12.4 pg/ml, median 1.7 vs. 8%) and frontal lobe involvement (82.8% vs. 6 days), more meningeal involvement (31.4% vs. Compared to the MOG-IgG-negative group, MOG-IgG-positive ADEM patients had a longer disease duration (median: 10 vs. They usually had a favorable outcome, while some suffered from relapse. ![]() Thirty-five patients (21 males and 14 females) in the MOG-IgG-positive group with encephalopathy, multifocal neurological symptoms, and typical magnetic resonance imaging (MRI) abnormalities were enrolled. We analyzed the clinical characteristics of MOG-IgG-positive ADEM pediatric patients and conducted a comparative analysis between the two groups. The patients were divided into two groups: MOG- immunoglobulin G (IgG) positive ( n = 35) and MOG-IgG negative ( n = 50). MethodsĪ retrospective study was conducted and enrolled pediatric ADEM patients who underwent serum MOG antibody detection from May 2017 to August 2020. To explore the clinical characteristics and related factors of children with acute disseminated encephalomyelitis (ADEM) with positive anti-myelin oligodendrocyte glycoprotein (MOG) antibody.
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