Nuffield Department of Clinical Neurosciences (Y.H., M.W., J.P., A.V., M.L., P.W.), John Radcliffe Hospital, University of Oxford, UK; Children's Neurosciences (M.A., M.L.), Evelina Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London, UK; Assistance Publique Hôpitaux de Paris (K.D., M.T.), Hopitaux Universitaires Paris Sud, France; Pediatric Neurology Department and National Referral Center for Neuroinflammatory Diseases (K.D., M.T.), Université Paris Sud, Le Kremlin-Bicêtre, Paris, France; Department of Paediatric Neurology (C.H.), Great Ormond Street Hospital for Children, London, UK; Department of Neurology and Center of Clinical Neuroscience (P.N.), General University Hospital in Prague, Czech Republic; First Faculty of Medicine (P.N.), Charles University in Prague, Czech Republic; and Department of Paediatric Neurology (E.W.), Birmingham Children's Hospital, UK.
Neurol Neuroimmunol Neuroinflamm. 2015 Mar 12;2(2):e81. doi: 10.1212/NXI.0000000000000081. eCollection 2015 Apr.
To determine whether myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) were predictive of a demyelination phenotype in children presenting with acquired demyelinating syndrome (ADS).
Sixty-five children with a first episode of ADS (12 acute disseminated encephalomyelitis, 24 optic neuritis, 18 transverse myelitis, 11 other clinically isolated syndrome) were identified from 2 national demyelination programs in the United Kingdom and France. Acute serum samples were tested for MOG-Abs by cell-based assay. Antibodies were used to predict diagnosis of multiple sclerosis (MS) at 1 year.
Twenty-three of 65 (35%) children had MOG-Abs. Antibody-positive and antibody-negative patients were not clinically different at presentation, but identification of MOG-Abs predicted a non-MS course at 1-year follow-up: only 2/23 (9%) MOG-Ab-positive patients were diagnosed with MS compared to 16/42 (38%) MOG-Ab-negative patients (p = 0.019, Fisher exact test). Antibody positivity at outset was a useful predictor for a non-MS disease course, with a positive predictive value of 91% (95% confidence interval [CI] 72-99), negative predictive value of 38% (95% CI 24-54), positive likelihood ratio of 4.02 (CI 1.0-15.4), and odds ratio of 6.5 (CI 1.3-31.3).
MOG-Abs are found at presentation in 35% of patients with childhood ADS, across a range of demyelinating disorders. Antibody positivity can be useful in predicting a non-MS disease course at onset.
确定髓鞘少突胶质细胞糖蛋白抗体（MOG-Abs）是否可预测发生获得性脱髓鞘综合征（ADS）的儿童出现脱髓鞘表型。
从英国和法国的 2 个脱髓鞘项目中确定了 65 名患有首发 ADS 的儿童（12 例急性播散性脑脊髓炎、24 例视神经炎、18 例横贯性脊髓炎、11 例其他临床孤立综合征）。通过细胞基础测定法对急性血清样本进行 MOG-Abs 检测。抗体用于预测 1 年后多发性硬化症（MS）的诊断。
65 名儿童中有 23 名（35%）存在 MOG-Abs。抗体阳性和抗体阴性患者在发病时无临床差异，但 MOG-Abs 的鉴定可预测 1 年随访时非 MS 病程：仅 23 名 MOG-Ab 阳性患者中有 2 名（9%）被诊断为 MS，而 42 名 MOG-Ab 阴性患者中有 16 名（38%）（p=0.019，Fisher 确切检验）。起始时的抗体阳性是 MS 疾病非进展的有用预测指标，阳性预测值为 91%（95%CI 72-99），阴性预测值为 38%（95%CI 24-54），阳性似然比为 4.02（CI 1.0-15.4），优势比为 6.5（CI 1.3-31.3）。
在儿童 ADS 患者中，MOG-Abs 在发病时可在 35%的患者中发现，涵盖一系列脱髓鞘疾病。抗体阳性可有助于预测起病时的非 MS 疾病病程。
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