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Tytuł:
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Clinical presentation and prognosis in MOG-antibody disease: a UK study.
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Autorzy:
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Jurynczyk M; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Messina S; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Woodhall MR; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Raza N; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Everett R; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Roca-Fernandez A; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Tackley G; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Hamid S; NMO Clinical Service, The Walton Centre, Liverpool, UK.
Sheard A; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Reynolds G; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Chandratre S; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Hemingway C; Department of Neurology, Great Ormond Street Hospital for Children, London, UK.
Jacob A; NMO Clinical Service, The Walton Centre, Liverpool, UK.
Vincent A; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Leite MI; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Waters P; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Palace J; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
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Źródło:
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Brain : a journal of neurology [Brain] 2017 Dec 01; Vol. 140 (12), pp. 3128-3138.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Oxford : Oxford University Press
Original Publication: London.
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MeSH Terms:
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Autoantibodies/*blood
Myelin-Oligodendrocyte Glycoprotein/*blood
Neuromyelitis Optica/*blood
Neuromyelitis Optica/*epidemiology
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cohort Studies ; Disabled Persons ; Female ; Humans ; Infant ; Male ; Middle Aged ; Neuromyelitis Optica/diagnosis ; Prognosis ; United Kingdom/epidemiology ; Young Adult
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Contributed Indexing:
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Keywords: acute disseminated encephalomyelitis; demyelination; multiple sclerosis; neuroinflammation; neuromyelitis optica
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Substance Nomenclature:
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0 (Autoantibodies)
0 (MOG protein, human)
0 (Myelin-Oligodendrocyte Glycoprotein)
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Entry Date(s):
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Date Created: 20171115 Date Completed: 20190523 Latest Revision: 20220321
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Update Code:
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20240105
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DOI:
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10.1093/brain/awx276
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PMID:
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29136091
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See de Seze (doi:10.1093/brain/awx292) for a scientific commentary on this article. A condition associated with an autoantibody against MOG has been recently recognized as a new inflammatory disease of the central nervous system, but the disease course and disability outcomes are largely unknown. In this study we investigated clinical characteristics of MOG-antibody disease on a large cohort of patients from the UK. We obtained demographic and clinical data on 252 UK patients positive for serum immunoglobulin G1 MOG antibodies as tested by the Autoimmune Neurology Group in Oxford. Disability outcomes and disease course were analysed in more detail in a cohort followed in the Neuromyelitis Optica Oxford Service (n = 75), and this included an incident cohort who were diagnosed at disease onset (n = 44). MOG-antibody disease affects females (57%) slightly more often than males, shows no ethnic bias and typically presents with isolated optic neuritis (55%, bilateral in almost half), transverse myelitis (18%) or acute disseminated encephalomyelitis-like presentations (18%). In the total Oxford cohort after a median disease duration of 28 months, 47% of patients were left with permanent disability in at least one of the following: 16% patients had visual acuity ≤6/36 in at least one eye, mobility was limited in 7% (i.e. Expanded Disability Status Scale ≥ 4.0), 5% had Expanded Disability Status Scale ≥ 6.0, 28% had permanent bladder issues, 20% had bowel dysfunction, and 21% of males had erectile dysfunction. Transverse myelitis at onset was a significant predictor of long-term disability. In the incident cohort 36% relapsed after median disease duration of 16 months. The annualized relapse rate was 0.2. Immunosuppression longer than 3 months following the onset attack was associated with a lower risk of a second relapse. MOG-antibody disease has a moderate relapse risk, which might be mitigated by medium term immunosuppression at onset. Permanent disability occurs in about half of patients and more often involves sphincter and erectile functions than vision or mobility.
Comment in: Brain. 2017 Dec 1;140(12):3072-3075. (PMID: 29194504)
Erratum in: Brain. 2018 Apr 1;141(4):e31. (PMID: 29373643)
