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Persisting myelin oligodendrocyte glycoprotein antibodies in aquaporin-4 antibody negative pediatric neuromyelitis optica

Mult Scler. 2013 Jul;19(8):1052-9. doi: 10.1177/1352458512470310. Epub 2012 Dec 20.

Rostásy KMader SHennes ESchanda KGredler VGuenther ABlaschek AKorenke CPritsch MPohl DMaier OKuchukhidze GBrunner-Krainz M,Berger TReindl M.

Source

Department of Pediatrics I, Innsbruck Medical University, Austria.

Abstract

BACKGROUND:
Recently we showed that antibodies to myelin oligodendrocyte glycoprotein (MOG) can be found in aquaporin-4 (AQP4)-immunoglobulin (IgG) seronegative pediatric and adult patients with definite and high-risk neuromyelitis optica (NMO).
OBJECTIVE:
The purpose of this study was to describe the clinical characteristics and temporal dynamics of MOG-IgG in AQP4-IgG seronegative pediatric patients presenting with definite NMO.
METHODS:
Children with definite NMO who were referred for further testing of serum antibodies for AQP4 and MOG with a cell-based assay were included in this study. Clinical disease course, cerebrospinal fluid and magnetic resonance imaging (MRI) studies of these patients were reviewed.
RESULTS:
Between 2008 and 2012 eight children who fulfilled the diagnostic criteria of definite NMO were recruited. Two children with definite NMO tested positive for AQP4-IgG but were negative for MOG-IgG antibodies. Three children had an absence of AQP4-IgG and MOG-IgG antibodies. Three children with definite NMO had high titers of serum MOG-IgG antibodies (≥1: 160), but no AQP4-directed humoral immune response. Longitudinal analysis of serum samples of the latter three children showed persisting high MOG-IgG titers over time.
CONCLUSION:
Pediatric patients presenting with clinical symptoms and MRI findings highly suggestive of NMO but with high and persisting MOG-IgG antibody titers are most likely to represent a distinct subgroup of acute demyelinating diseases with important clinical and therapeutic implications.
PMID: 23257621 [PubMed – in process]
http://www.ncbi.nlm.nih.gov/pubmed/23257621