Department of Neurology, Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, Binjiang District, Hangzhou City, 310052, P.R. China.
Department of Child Psychology, Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, Binjiang District, Hangzhou City, 310052, P.R. China.
BMC Neurol. 2022 Nov 9;22(1):418. doi: 10.1186/s12883-022-02963-0.
To explore the clinical characteristics and related factors of children with acute disseminated encephalomyelitis (ADEM) with positive anti-myelin oligodendrocyte glycoprotein (MOG) antibody.
A retrospective study was conducted and enrolled pediatric ADEM patients who underwent serum MOG antibody detection from May 2017 to August 2020. The patients were divided into two groups: MOG- immunoglobulin G (IgG) positive (n = 35) and MOG-IgG negative (n = 50). We analyzed the clinical characteristics of MOG-IgG-positive ADEM pediatric patients and conducted a comparative analysis between the two groups.
Thirty-five patients (21 males and 14 females) in the MOG-IgG-positive group with encephalopathy, multifocal neurological symptoms, and typical magnetic resonance imaging (MRI) abnormalities were enrolled. They usually had a favorable outcome, while some suffered from relapse. Compared to the MOG-IgG-negative group, MOG-IgG-positive ADEM patients had a longer disease duration (median: 10 vs. 6 days), more meningeal involvement (31.4% vs. 8%) and frontal lobe involvement (82.8% vs. 68%), higher relapse rates (14.3% vs. 2%), lower serum tumor necrosis factor (1-12.4 pg/ml, median 1.7 vs. 1-34 pg/ml, median 2.2) and interferon-gamma (1-9.4 pg/ml, median 1.3 vs. 1-64 pg/ml, median 3) (P < 0.05, respectively). Multivariate logistic regression analysis showed that the longer disease duration, meningeal involvement and frontal lobe involvement were the correlated factors of patients with ADEM with MOG antibody (P < 0.05).
Our findings provide clinical evidence that MOG-IgG positivity is associated with longer disease duration, meningeal involvement, and frontal lobe involvement.
探讨抗髓鞘少突胶质细胞糖蛋白（MOG）抗体阳性的急性播散性脑脊髓炎（ADEM）患儿的临床特征及相关因素。
回顾性研究纳入 2017 年 5 月至 2020 年 8 月期间行血清 MOG 抗体检测的儿科 ADEM 患者，将患者分为 MOG-IgG 阳性组（n=35）和 MOG-IgG 阴性组（n=50）。分析 MOG-IgG 阳性 ADEM 患儿的临床特征，并对两组进行比较分析。
MOG-IgG 阳性组纳入 35 例（男 21 例，女 14 例）以脑病、多灶性神经症状和典型磁共振成像（MRI）异常为表现的患者，他们通常预后良好，但也有复发的情况。与 MOG-IgG 阴性组相比，MOG-IgG 阳性 ADEM 患者的病程更长（中位数：10 天比 6 天），脑膜受累更多（31.4%比 8%）和额叶受累更多（82.8%比 68%），复发率更高（14.3%比 2%），血清肿瘤坏死因子（1-12.4 pg/ml，中位数 1.7 比 1-34 pg/ml，中位数 2.2）和干扰素-γ（1-9.4 pg/ml，中位数 1.3 比 1-64 pg/ml，中位数 3）水平更低（P<0.05）。多变量逻辑回归分析显示，病程较长、脑膜受累和额叶受累是 MOG 抗体阳性 ADEM 患者的相关因素（P<0.05）。
我们的研究结果提供了临床证据，表明 MOG-IgG 阳性与病程较长、脑膜受累和额叶受累相关。
