Background@#and
Purpose:
The
myelin oligodendrocyte glycoprotein (MOG) antibody is detected at a high rate in childhood acquired demyelinating
syndrome (ADS). This study aimed to determine the diagnostic value of the MOG antibody in ADS and the spectrum of MOGantibody-positive
demyelinating diseases in
children. @*
Methods@#This study included 128
patients diagnosed with ADS (n=94) or unexplained
encephalitis (n=34). The MOG antibody in
serum was tested using an in-house live-
cell-based
immunofluorescence assay. @*Results@#The MOG antibody was detected in 48
patients (46 ADS
patients and 2
encephalitis patients, comprising 23
males and 25
females).
Acute disseminated encephalomyelitis (ADEM) (35.4%) was the most-common
diagnosis, followed by the unclassified form (17.4%), isolated
optic neuritis (ON) (15.2%),
neuromyelitis optica spectrum disorder (13.0%),
multiple sclerosis (MS) (10.8%), other clinically isolated
syndromes [monophasic event except ADEM, isolated ON, or
transverse myelitis (TM)] (8.7%), and unexplained
encephalitis (4.3%). At the initial presentation, 35 out of the 46
patients with ADS had
brain lesions detected in
magnetic resonance imaging, and 54% of these 35
patients had
encephalopathy. Nine of the 11
patients without
brain lesions exhibited only ON. Thirty-nine percent of the
patients experienced a multiphasic event during the mean follow-up period of 34.9 months (range 1.4–169.0 months).
Encephalopathy at the initial presentation was frequently confirmed in the monophasic group (p= 0.011). @*Conclusions@#MOG
antibodies were identified in all pediatric ADS
phenotypes except for monophasic TM. Therefore, the MOG antibody test is recommended for all pediatric
patients with ADS, especially before a
diagnosis of MS and for
patients without a clear
diagnosis.