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KMID : 1130620200160030461
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Journal of Clinical Neurology
2020 Volume.16 No. 3 p.461 ~ p.469
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Clinical Spectrum of Myelin Oligodendrocyte Glycoprotein-Immunoglobulin G-Associated Disease in Korean Children
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Yoo Il-Han
Kim Woo-Joong
Shim Young-Kyu
Choi Sun-Ah
Kim Soo-Yeon
Kim Hun-Min
Lim Byung-Chan
Hwang Hee
Choi Ji-Eun
Kim Ki-Joong
Kim Ye-Seul
Hyun Jae-Won
Kim Su-Hyun
Choi Kyung-Ho
Kim Ho-Jin
Chae Jong-Hee
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Abstract
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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 MOG-antibody-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.
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KEYWORD
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demyelinating disease, myelin oligodendrocyte glycoprotein, antibodies
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