Clinical and imaging features of 13 children with myelin oligodendrocyte glycoprotein antibody encephalomyelitis / 中华实用儿科临床杂志

ABSTRACT

Objective@#To investigate the clinical and imaging features of myelin oligodendrocyte glycoprotein antibody(MOG) encephalomyelitis in children.@*Methods@#The clinical, laboratory finding, imaging and follow-up data of 13 children with MOG encephalomyelitis (MOG-EM) diagnosed by Children′s Hospital of Nanjing Medical University from December 2016 to December 2018 were retrospectively analyzed.@*Results@#Among the 13 children, 4 cases were male and 9 cases were female, the median age was 8 years old and 1 month.Symptoms of the first episode included fever, drowsiness in 2 cases, visual acuity in 5 cases, convulsions in 3 cases, urinary retention in 2 cases, and ataxia in 2 cases.Abnormalities were found in 12 cases by the head magnetic resonance imaging(MRI), most of which showed extensive or isolated subcortical white matter lesions, and a few deep gray matter nuclei and brainstem were involved; 3 cases of spinal MRI abnormalities, mainly characterized by long segmental transverse myelitis; 6 cases optic nerve MRI abnormalities were found in 6 cases, manifested as disease side optic nerve or optic chiasm abnormal signals; the titer of serum MOG antibody was 110-1320 in 13 cases.All children responded well to glucocorticoids and gamma globulin, and all symptoms were alleviated after treatment.Two patients had recurrence during the follow-up period, which was characterized by optic neuritis.After azathioprine addition, there was no recurrence after 1 to 2 years of follow-up.@*Conclusions@#Children with MOG antibody encephalomyelitis present a decline in visual acuity commonly.The images are mainly acute disseminated encephalomyelitis-like changes, immunosuppressive therapy is effective, generally with a better prognosis.