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Abstract Details

Increased Likelihood of Relapse in Pediatric Anti-MOG Acute Disseminated Encephalomyelitis (ADEM) and Optic Neuritis (ON) vs. Seronegative ADEM and ON Patients
Autoimmune Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
15-001

To determine correlation between MOG antibody status and symptom recurrence within three months of presentation.  We present 22 patients who presented to Texas Children’s Hospital January 2018 - September 2019 diagnosed with ADEM and/or ON, characterizing presentation, presence of ant-MOG antibodies, and relapse rates. 

ADEM is most commonly monophasic.  While uncommon, new symptoms developing within three months of presentation are considered part of initial event.  The presence of myelin oligodendrocyte glycoprotein (MOG) antibodies has been associated with relapse more than three months from initial presentation.  The relationship between MOG antibodies and new symptomatology within first three months is unknown.  
Retrospective chart review of patients diagnosed with ADEM and/or ON and tested for MOG antibodies.  Charts reviewed for evidence of new MRI lesions or new symptoms.
22 patients were identified with a mean age of 8.0 years. 16 patients (72.7%) were found to be antibody positive.  At presentation, 17 patients were diagnosed with ADEM (12 MOG Ab positive), 3 with ON (2 MOG Ab positive), and 2 with ADEM and ON (both MOG Ab positive).  5 patients developed recurring attacks, with new symptoms and MRI findings of new lesion with contrast enhancement.  Of these, all were positive for anti-MOG antibody, with an overall rate in the anti-MOG antibody population of 31.2%.  4 of these patients had new symptomatology within 3 months from presentation.   All patients with recurrent attacks had an initial diagnosis of ADEM, with subsequent events including ADEM, ADEM and ON, and solely ON. Additionally, 3 patients have had more than one subsequent attack. 
Higher rates of relapse were seen in anti-MOG ADEM and ON in comparison to those who are seronegative.  It was also found these patients are at increased risk of recurrent attacks less than 3 months from presentation, which is varying from the current classification of multiphasic ADEM.  
Authors/Disclosures
Kristen Fisher, DO (Baylor College of Medicine)
PRESENTER 		Dr. Fisher has nothing to disclose.
Alfred Balasa, MD Dr. Balasa has nothing to disclose.
Nikita Shukla, MD (BCM) The institution of Dr. Shukla has received research support from Roche.
Timothy E. Lotze, MD, FÂ鶹´«Ã½Ó³»­ (Texas Children's Hospital) Dr. Lotze has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Department of Justice VICP. The institution of Dr. Lotze has received research support from NIH. The institution of Dr. Lotze has received research support from National MS Society. The institution of Dr. Lotze has received research support from Sarepta Therapeutics. The institution of Dr. Lotze has received research support from PTC THERAPEUTICS. The institution of Dr. Lotze has received research support from Avexis. Dr. Lotze has received publishing royalties from a publication relating to health care. Dr. Lotze has received publishing royalties from a publication relating to health care.