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髓鞘少突胶质细胞糖蛋白抗体阳性患者的临床、人口统计学和影像学特征。

Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein.

机构信息

Department of Neuroscience, Ondokuz Mayıs University Institute of Graduate Studies, Samsun, Türkiye

Department of Neurology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye

出版信息

Balkan Med J. 2024 Jul 5;41(4):272-279. doi: 10.4274/balkanmedj.galenos.2024.2024-1-97. Epub 2024 Jun 3.

Abstract

BACKGROUND

Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited.

AIMS

To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG.

STUDY DESIGN

Multicenter, retrospective, observational study.

METHODS

Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University’s Faculty of Medicine were included in the study.

RESULTS

Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients.

CONCLUSION

For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.

摘要

背景

视神经炎、脊髓炎和视神经脊髓炎谱系疾病(NMOSD)与髓鞘少突胶质细胞糖蛋白免疫球蛋白 G(抗 MOG-IgG)抗体有关。此外,具有视神经炎和脊髓炎的多发性硬化症(MS)放射学和人口统计学特征不典型的患者也表现出抗水通道蛋白-4 和抗 MOG-IgG 抗体。然而,关于抗 MOG-IgG 患者的诊断、治疗、随访和预后的数据有限。

目的

评估抗 MOG-IgG 患者的临床、放射学和人口统计学特征。

研究设计

多中心、回顾性、观察性研究。

方法

本研究纳入了在奥登纽克迈希斯大学医学院神经免疫学实验室进行了抗 MOG-IgG 检测的患者。

结果

在 104 例抗 MOG-IgG 患者中,56.7%为女性,43.3%为男性。约 2.4%的患者被诊断为 MS,15.8%为急性播散性脑脊髓炎(ADEM),39.4%为 NMOSD,31.3%为单纯视神经炎,11.1%为单纯脊髓炎。约 53.1%的脊髓炎患者在发病时表现为 NMOSD 临床病程。此后,其中 8.8%的患者表现出类似于 MS 和 ADEM 的临床病程,28.1%的患者表现出单纯脊髓炎的临床病程。在发病时年龄大于 40 岁的患者中,急性发作治疗的反应较低,残疾程度较高。15.5%的患者检测到寡克隆带。

结论

对于 NMOSD 患者且无抗 NMO 抗体,抗 MOG-IgG 的存在支持诊断。此外,发病时年龄较大、发病时扩展残疾状态量表(EDSS)评分、脊髓受累和发作次数可能是抗 MOG-IgG 患者的不良预后因素。

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