Antibodies to myelin oligodendrocyte glycoprotein in bilateral and recurrent optic neuritis

Ramanathan, Sudarshini; Reddel, Stephen W.; Henderson, Andrew; Parratt, John; Barnett, Michael; Gatt, Prudence N.; Merheb, Vera; Kumaran, Raani-Yogeeta Anusuiya; Pathmanandavel, Karrnan; Sinmaz, Nese; Ghadiri, Mahtab; Yiannikas, Con; Vucic, Steve; Stewaert, Graeme; Bleasel, Andrew; Booth, David R.; Fung, Victor S.C.; Dale, Russell C.; Brilot, Fabienne

doi:10.1016/j.jneuroim.2014.08.065

Cited by 67 publications

(125 citation statements)

References 28 publications

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“…6,7 Two studies showed that MOG-Ab patients were more likely to present with bilateral optic neuritis as their initial symptom. 8,9 Unlike our patient, some studies found that people with MOG-Abs were more likely to have LEM involving the lumbar spine and conus. 7,8 Similar to our patient, one of these studies found that MOG-Ab patients were more likely to present with urinary retention before weakness.…”

Section: Go To Sectioncontrasting

confidence: 57%

Clinical Reasoning: A man with rapidly ascending paralysis

2017

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A 38-year-old construction worker with no medical history presented with back pain, urinary retention, and flaccid lower extremity paralysis. Three weeks prior to presentation, he fell from a ladder with no immediate injury. Two weeks after the fall, he presented to another hospital for back pain and urinary retention. MRI of the lumbar, cervical, and thoracic spine without contrast were reportedly normal, and his back pain improved with an oral methylprednisolone dose pack (figure). The urinary retention remained, and he was discharged with an indwelling catheter. Within a week of the initial urinary symptoms,

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Section: Go To Sectioncontrasting

confidence: 57%

Clinical Reasoning: A man with rapidly ascending paralysis

2017

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“…However, MOG-Ab has been reported to be seen in a range of phenotypes from monophasic ON with LETM [26] to monophasic or relapsing ON [27][28][29][30] or childhood ADEM [31][32][33]. Male gender predominance [27,28,30], younger onset age [27,30], a good response to corticosteroids and good outcome [27,28,30] have been reported, along with typical MRI appearances of brain deep gray matter and conus involvement [27,28].…”

Section: Discussionmentioning

confidence: 99%

Isolated new onset ‘atypical’ optic neuritis in the NMO clinic: serum antibodies, prognoses and diagnoses at follow-up

et al. 2015

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Severe, recurrent or bilateral optic neuritis (ON) often falls within the neuromyelitis optica spectrum disorders (NMOSD), but the diagnosis can be particularly challenging and has important treatment implications. We report the features, course and outcomes of patients presenting with atypical ON when isolated at onset. We retrospectively analyzed 69 sequential patients referred to a single UK NMO center with isolated ON at onset. Aquaporin-4 antibody (AQP4-Ab) assessment was performed in all patients and IgG1 myelin-oligodenrocyte glycoprotein (MOG-Ab) in AQP4-Ab(neg) patients. 37 AQP4-Ab positive (AQP4-Ab(pos)) and 32 AQP4-Ab negative (AQP4-Ab(neg)) patients (8 with MOG-Ab) were identified. The AQP4-Ab(neg) group included heterogeneous diagnoses: multiple sclerosis (MS), NMO, relapsing isolated ON (RION), monophasic isolated ON and relapsing acute disseminated encephalomyelitis (ADEM)-like syndromes. Compared to AQP4-Ab(neg) patients, AQP4-Ab(pos) patients had a worse residual visual outcome from first attack (median VFSS 4 vs. 0, p = 0.010) and at last assessment (median VFSS 5 versus 2, p = 0.005). However, AQP4-Ab(neg) patients with RION also had poor visual outcome. Up to 35% of AQP4-Ab(neg) patients developed a LETM and two developed low positivity for AQP4-Ab over time. Eight AQP4-Ab(neg) patients (25%) were MOG-Ab positive, covering a range of phenotypes excluding MS; the first ON attack was often bilateral and most had relapsing disease with a poor final visual outcome [VFSS 4, range (0-6)]. In conlcusion, AQP4-Ab positivity is confirmed as a predictor of poor visual outcome but AQP4-Ab(neg) RION also had a poor visual outcome. Of those without AQP4-Ab, 25% had MOG-Ab and another 25% developed MS; thus, MOG-Ab is associated with AQP4-Ab(neg) non-MS ON.

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“…This antibody is significantly associated with bilateral optic neuritis and can play the role of clinical biomarker. Anti-MOG antibody-associated bilateral ON, which is a relapsing disorder, is frequently steroid dependent (33). And as Tsuburaya stated, recurrent ON patients are candidates for serum anti-MOG antibody analysis (34).…”

Section: Anti-mog Antibodies In Optic Neuritismentioning

confidence: 99%