Multiple sclerosis and related disorders · 2025
Clinico-investigational profile, relapse predictors and outcomes of pediatric patients with anti-myelin oligodendrocyte associated disorders: An experience from tertiary centre.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dhar Debjyoti, Roy Subhajit, Kenchaiah Raghavendra, Mondal Mahammad Samim, Kumar Seetam, Nashi Saraswati, Rao Shilpa, Santhoshkumar Rashmi, Mahale Rohan, Ar Nagaraj, Mathur Sahil, Mailankody Pooja, Bhat Maya Dattatraya, Mahadevan Anita, Padmanabha Hansashree
Аннотация
BACKGROUND: The data on relapse and outcome predictors in pediatric anti-Myelin oligodendrocyte antibody associated diseases (MOGAD) is poorly delineated in the literature.
METHODS: We performed a retrospective study of the clinico-investigational profile of pediatric patients (age<18 years) who met the international diagnostic criteria for MOGAD, 2023 and assessed the predictors for clinical relapse and equated the trajectory of outcomes over a long-term follow-up.
RESULTS: We recruited 46 children (males=24, 52.2 %), with a median age at onset 11(8 to 16) years and a median duration of 15 (IQR 6-45) days. The core demyelinating events observed were optic neuritis (n = 19, 41.3 %), acute disseminating encephalomyelitis (n = 13, 28.3 %), transverse myelitis (n = 10, 21.7 %), cerebral deficits (n = 3, 6.5 %), brainstem/cerebellar syndrome (n = 2, 4.3 %), cerebral cortical encephalitis (n = 2, 4.3 %) and atypical presentations (n = 1, 2.2 %). Prevalence of ADEM was significantly higher among children <10 years (p = 0.046). At a median follow-up of 28 months, ON was significantly associated with relapse, with an odds ratio (OR) of 5.175 (95 % CI 1.286-20.824, p = 0.021), unlike other core demyelinating events. In 11 cases (23.9 %) referral diagnosis was not MOGAD. Neither the degree of serum anti-MOG antibody positivity [strong vs weak: OR 1.506 (0.407 to 5.578), p = 0.480] nor its persistence [OR 0.955 (0.201 to 4.538), p = 0.953] were identified to be relapse predictors. There was a significant improvement in modified Rankin scale (mRS) scores between presentation, intermediate and at last follow-up (p < 0.001).
CONCLUSIONS: The study highlights the predictors for relapse, and presents a follow-up data of >2 years on pediatric MOGAD. It reveals optic neuritis as a risk factor for relapse. The study emphasises the importance of a broad range of antibody testing including anti-MOG in patients with suspected autoimmune encephalitis.
METHODS: We performed a retrospective study of the clinico-investigational profile of pediatric patients (age<18 years) who met the international diagnostic criteria for MOGAD, 2023 and assessed the predictors for clinical relapse and equated the trajectory of outcomes over a long-term follow-up.
RESULTS: We recruited 46 children (males=24, 52.2 %), with a median age at onset 11(8 to 16) years and a median duration of 15 (IQR 6-45) days. The core demyelinating events observed were optic neuritis (n = 19, 41.3 %), acute disseminating encephalomyelitis (n = 13, 28.3 %), transverse myelitis (n = 10, 21.7 %), cerebral deficits (n = 3, 6.5 %), brainstem/cerebellar syndrome (n = 2, 4.3 %), cerebral cortical encephalitis (n = 2, 4.3 %) and atypical presentations (n = 1, 2.2 %). Prevalence of ADEM was significantly higher among children <10 years (p = 0.046). At a median follow-up of 28 months, ON was significantly associated with relapse, with an odds ratio (OR) of 5.175 (95 % CI 1.286-20.824, p = 0.021), unlike other core demyelinating events. In 11 cases (23.9 %) referral diagnosis was not MOGAD. Neither the degree of serum anti-MOG antibody positivity [strong vs weak: OR 1.506 (0.407 to 5.578), p = 0.480] nor its persistence [OR 0.955 (0.201 to 4.538), p = 0.953] were identified to be relapse predictors. There was a significant improvement in modified Rankin scale (mRS) scores between presentation, intermediate and at last follow-up (p < 0.001).
CONCLUSIONS: The study highlights the predictors for relapse, and presents a follow-up data of >2 years on pediatric MOGAD. It reveals optic neuritis as a risk factor for relapse. The study emphasises the importance of a broad range of antibody testing including anti-MOG in patients with suspected autoimmune encephalitis.