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Neuropediatrics 2022; 53(05): 351-357
DOI: 10.1055/a-1863-1862
Original Article

Seroprevalence of MOG and AQP4 Antibodies and Outcomes in an Indian Cohort of Pediatric Acquired Demyelinating Syndromes

Naveen Sankhyan
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Amit Rawat
2   Pediatric Allergy and Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Sameer Vyas 
3   Section of Neuroimaging and Interventional Radiology, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Jitendra Kumar Sahu
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Chandana Bhagwat
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Priyanka Madaan
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Lokesh Saini 
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Arushi Gahlot Saini 
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Renu Suthar
1   Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Jaspreet Sukhija
4   Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Murlidharan Jayashree
5   Pediatric Critical Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations Funding The study was supported by a grant from Postgraduate Institute of Medical Education and Research, Chandigarh (No.71/2-Edu-16/ 4774; Nov 11, 2017).
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Abstract

This study aimed to determine the seropositivity of myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) and aquaporin-4 antibodies (AQP4-Ab) and outcomes in children with acquired demyelinating syndromes (ADSs). Children (6 months–15 years) with suspected ADS were enrolled and tested for MOG-Ab and AQP4-Ab prospectively over 18 months at a tertiary care hospital in North India. Children with proven nonimmune-mediated neurological disorders were enrolled as controls. Of 79 children with suspected ADS, 66 were enrolled. Among the enrolled children with ADS, acute demyelinating encephalomyelitis (ADEM) (25) was the most common first clinical event followed by optic neuritis (ON) (20) and transverse myelitis (TM) (19; one child had ON and TM simultaneously [neuromyelitis optica spectrum disorders [NMOSDs]]), while two children had clinically isolated syndrome (CIS) apart from ON and TM. Fourteen (21.2%, confidence interval [CI] 11.3–31.1) tested positive for one antibody (12 [18.1%; 95% CI 10.5–25.5%] for MOG-Ab and 2 [3%; 95% CI 0–7.2%] for AQP4-Ab). None of the 62 controls tested positive for any antibody. The final diagnosis in those with the monophasic ADS was ADEM (21), ON (13), TM (16), and other CIS (1) while that in children with recurrent events was multiphasic disseminated encephalomyelitis (MDEM) (2), NMOSD (3), ADEM-ON (4), recurrent ON (4), and MS (2). Among those with the first event, 4/51 (7.8%; 95% CI 0.5–15.2%) were MOG-Ab positive and 2 AQP4-Ab positive, whereas 8/15 (53.3% [95% CI 28.1–78.6%]) with recurrent events (MDEM [2], ADEM-ON [4], recurrent ON [1], and recurrent TM [1]) were MOG-Ab positive. Hence, MOG-Abs are the most common antibodies detected in one in five children with pediatric ADS, especially in relapsing disease. AQP4-Abs are rare in children with ADS.

Keywords

demyelination - children - MOG - AQP-4

Author Contributions

N.S.: Conceptualization of the study, facilitated the data collection, patient management, statistical analysis, and critical review of the manuscript, and review of literature. A.R.: Conceptualization of the study, facilitated the data collection, and autoantibody analysis. S.V.: Conceptualization of the study and interpretation of radiological data. J.K.S.: Conceptualization of the study, and facilitated data collection and patient management. C.B., L.S., A.G.S., R.S., J.M.: Facilitated data collection and patient management. P.M.: Facilitated data collection, patient management, reviewed the literature, and prepared the initial draft of the manuscript. J.S.: Ophthalmological testing of patients and its interpretation, and patient management. All the authors contributed to the manuscript.




Publication History

Received: 22 February 2022

Accepted: 24 May 2022

Accepted Manuscript online:
26 May 2022

Article published online:
24 July 2022

© 2022. Thieme. All rights reserved.

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