MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome
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Cites background from "MOG-IgG in NMO and related disorder..."
...%) and high annualized relapse risk (0.92) recently reported (Jarius et al., 2016a) may be overestimated because patients with onset prior to the availability of the antibody test will ordinarily only re-present and thus be diagnosed, if they relapse....
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...In a recent study including 50 MOG-antibody patients, severe visual impairment was present at last follow-up in 36% (defined as visual acuity 50.5 in one or both eyes) and markedly impaired ambulation in 25% patients (Jarius et al., 2016b)....
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...…remain largely unknown due to a relatively small number of patients included in previous studies and biases towards recruiting relapsing patients because monophasic patients could not be diagnosed at onset until the recent discovery of the disease (Kitley et al., 2014; Jarius et al., 2016a)....
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Cites background from "MOG-IgG in NMO and related disorder..."
...LETM has also been shown to be frequently present at disease onset in MOG-IgG-positive children with manifestations other than isolated ON (32/40 or 80% of all examined cases) [41] Present in 6/8 patients in [7] (at onset); 4/6 in [8]; 4/11 in [35]; 3/12 in [42]; 5/26 (not all had lumbar MRI) in [3]; and in 13/40 pediatric patients (at onset) with manifestations other than isolated ON [41] Ramanathan et al....
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...overlap [3, 14]: like MS, MOG-EM follows a relapsing...
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...: Neutrophilic pleocytosis is also frequently found in AQP4-IgG-positive NMOSD [51] Observed in 43% (14/36) of MOG-IgG-positive patients with pleocytosis (peak values) [3], but only rarely in patients with MS (≤ 2% according to [52]; 1/71 patient ≥ 15 years of age [range 15–29] in [53]) Oligoclonal bands (OCB) have been reported in up to 98% of patients with MS in central and Northern Europe [53] but only in around 12–13% of patients with MOG-EM in two recent Central European studies [3, 54]; of note, many MOG-EM patients previously falsely diagnosed with MS were atypical in that they had no OCB in a recent multicenter study [3]....
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...drugs approved for MS might be ineffective or even harmful in MOG-EM owing to differences in immunopathogenesis [3, 4, 15–17]; (b) MOG-EM is associated with a high risk of flare-ups after cessation of steroid treatment for acute attacks and may thus require close monitoring and careful steroid tapering [3, 18–22]; and (c) patients positive for MOG-IgG might be particularly responsive to antibody-depleting treatments for acute attacks such as plasma exchange or immunoadsorption [3, 4, 9, 14, 23, 24], to B cell-targeted long-term therapies such as rituximab, to treatment with intravenous immunoglobulins (IVIG) (especially in children [25]), and to immunosuppressive treatments [3, 6, 14, 25, 26]....
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...Longitudinal extensive lesions ranging over more than the half of the distance between the optic nerve head and the chiasm were also reported in 3/ 3 patients in [47] and in 6/10 (60%) in [3]....
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377 citations
References
13,564 citations
"MOG-IgG in NMO and related disorder..." refers background in this paper
...5 months since onset, median 52 [1-507] months), the disease took a relapsing course in most cases....
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8,883 citations
"MOG-IgG in NMO and related disorder..." refers background in this paper
...Seven out of 43 (16 %) patients with available data fulfilled both the clinicoradiological 2006 criteria for NMO [28] and the clinicoradiological 2010 McDonald criteria for MS [46]....
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...If MOG-IgG seropositivity is not considered to constitute per se a “better explanation” [46], i....
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...Thus more and more importance attaches to carefully considering the ‘negative’ criterion of ruling out other diagnoses (“no better explanation”) included in the current diagnostic consensus criteria for MS [46]....
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..., based solely on clinicoradiological criteria, 15/46 or 33 % of the patients with available data met the most current diagnostic criteria for MS [46] (Table 1)....
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...5 months since onset, median 52 [1-507] months), the disease took a relapsing course in most cases....
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2,945 citations
"MOG-IgG in NMO and related disorder..." refers background or methods in this paper
...longitudinally extensive (more than half the length of the corpus callosum), as considered typical for AQP4IgG-positive NMOSD [29], in 1/8 (12....
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...%) patients met the 2015 international consensus criteria for NMOSD [29] (Table 1)....
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...Both LEON lesions and chiasmatic lesions were previously thought to be indicative of (AQP4-IgG-positive) NMOSD [29]....
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...Other suspected diagnoses included acute disseminated EM (ADEM), multiphasic disseminated EM, AQP4-IgG-negative NMO according to Wingerchuk’s 2006 criteria [28], AQP4-IgGnegative NMOSD according to the 2015 international diagnostic consensus criteria [29], viral encephalitis, bacterial encephalitis, paraneoplastic encephalitis, isolated vasculitis of the CNS, chronic relapsing inflammatory optic neuropathy (CRION), CNS lymphoma, sarcoidosis, spinal stenosis, “spinal tumor of unknown dignity”, suspected spinal ischemia, para- or postinfectious ON, and myelitis; some patients were diagnosed with ON, rON, (longitudinally extensive transverse) myelitis, brainstem encephalitis or EM “of unknown origin”....
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...Keywords: Myelin oligodendrocyte glycoprotein antibodies (MOG-IgG), Autoantibodies, Neuromyelitis optica spectrum disorders (NMOSD), Aquaporin-4 antibodies (AQP4-IgG, NMO-IgG), Optic neuritis, Transverse myelitis, Longitudinally extensive transverse myelitis, Magnetic resonance imaging, Cerebrospinal fluid, Oligoclonal bands, Electrophysiology, Evoked potentials, Treatment, Therapy, Methotrexate, Azathioprine, Rituximab, Ofatumumab, Interferon beta, Glatiramer acetate, Natalizumab, Outcome, Pregnancy, Infections, Vaccination, Multiple sclerosis, Barkhof criteria, McDonald criteria, Wingerchuk criteria 2006 and 2015, IPND criteria, International consensus diagnostic criteria for neuromyelitis optica spectrum disorders...
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2,793 citations
"MOG-IgG in NMO and related disorder..." refers background in this paper
...5 months since onset, median 52 [1-507] months), the disease took a relapsing course in most cases....
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2,442 citations