Treatment of MOG-IgG associated disease in paediatric patients: A systematic review

Costa, Bruna Klein da; Banwell, Brenda; Sato, Douglas Kazutoshi

doi:10.1016/j.msard.2021.103216

Cited by 13 publications

(18 citation statements)

References 19 publications

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“…A systematic review of pediatric MOGAD included 61 studies, all but one of which used corticosteroids as acutephase treatment. However, IVIG was used in 21% (128/621) of patients and plasmapheresis was only performed in 4% (26/621) [9]. MOGAD is commonly well treated with intravenous steroids, but cases in which the patient is refractory to steroids or presents with severe symptoms such as total blindness could be managed with plasmapheresis and IVIG for a better prognosis, as observed in our case.…”

Section: A a B B C C D Dmentioning

confidence: 60%

A Case of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease with Acute Bilateral Total Blindness

Lee

et al. 2022

Ann Child Neurol

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Section: A a B B C C D Dmentioning

confidence: 60%

A Case of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease with Acute Bilateral Total Blindness

Lee

et al. 2022

Ann Child Neurol

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“…An intravenous high-dose of methylprednisolone has become the most common treatment to combat MOGAD in the acute phase, but there is no consensus on the necessity and drugs of long-term immunotherapy for MOGAD patients ( Klein da Costa et al, 2021 ). In our study, the clinical symptoms of eight patients receiving a high dose of methylprednisolone were alleviated or disappeared.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristic of myelin oligodendrocyte glycoprotein antibody associated cortical encephalitis in adults and outcomes following glucocorticoid therapy

Zhou²,

Ci³

et al. 2023

Front. Aging Neurosci.

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ObjectiveTo describe the clinical and radiological features, as well as outcomes following glucocorticoid therapy and recurrence in adults suffering from cortical encephalitis associated with myelin oligodendrocyte glycoprotein (MOG) antibody.MethodsThe clinical information of nine adult patients suffering from cortical encephalitis associated with MOG antibody admitted to the Affiliated Brain Hospital of Nanjing Medical University from 2020 to 2022 was systematically reviewed. The clinical symptoms, laboratory data, imaging results, outcomes following glucocorticoid therapy and recurrence were evaluated.ResultA total of 9 patients positive for MOG antibody and suffering from cortical encephalitis were included in our study (55.6% men, median age 29 years, 15–57 years). The most common clinical symptoms included headache (77.8%), fever (66.7%), and generalized seizures (55.6%). Some patients also experienced limb shaking (22.2%), leg numbness (22.2%), transient motor aphasia (11.1%), and vision loss (11.1%). The main features of cerebrospinal fluid () examination were increased intracranial pressure, pleocytosis, and elevated cerebrospinal fluid (CSF) protein. In addition, N-methyl-D-aspartate receptor (NMDAR) and MOG antibodies were found in the CSF of 3 patients, and NMDAR, MOG, and glial fibrillary acidic protein antibodies were found in the CSF of 1 patient. All patients were subjected to magnetic resonance imaging (MRI) and the images of eight of them showed T2 and/flair image hyperintense lesions, three showed meningeal or lesion enhancement and four showed white matter lesions, which were mostly located in the midline structures (75%). All patients received glucocorticoid therapy in the acute phase and in remission, and eight of them received an intravenous high dose of methylprednisolone, including one patient who received a simultaneous immunoglobulin therapy. One patient was treated with low-dose prednisolone tablets. Seven (77.8%) patients were wholly recovered at discharge, and 2 (22.2%) patients were left with slight symptoms. During the median 9-month follow-up (range: 2–36 months), 2 (22.2%) patients developed recurrence.ConclusionThe clinical manifestations of adult MOG antibody-associated cortical encephalitis were significantly different from those of the typical MOG antibody-associated disease (MOGAD). Patients in the acute phase of the disease were prone to show signs similar to central nervous system infection, requiring clinicians to have the ability to recognize the disease to avoid misdiagnosis. In addition, seizures were common in MOG antibody-related encephalitis, and the type of seizures was age-related. Brain MRI results showed that the distribution of cerebral cortex lesions was closely related to the classification of cortical encephalitis. Based on the patient’s response to the treatment, glucocorticoid therapy was effective against MOG antibody-associated cortical encephalitis, which is consistent with the treatment response and clinical prognosis of MOGAD. Therefore, our opinion was that MOG antibody might be the “responsible antibody” in MOG antibody-associated cortical encephalitis, although further studies are needed to confirm this hypothesis.

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“…Second, we observed a marked clinical and magnetic resonance imaging response with steroids as previously reported; i.v. methylprednisolone followed by tapered oral prednisolone is considered the first‐line treatment for acute relapses 7 . Intravenous immunoglobulin with doses ranging from 1 to 2 g/kg in 2–5 days or 400 mg/kg/day in 5 days or plasma exchange 3–7 cycles are commonly used in severe, life threatening or refractory cases 7 .…”

Section: Discussionmentioning

confidence: 99%

“…methylprednisolone followed by tapered oral prednisolone is considered the first‐line treatment for acute relapses 7 . Intravenous immunoglobulin with doses ranging from 1 to 2 g/kg in 2–5 days or 400 mg/kg/day in 5 days or plasma exchange 3–7 cycles are commonly used in severe, life threatening or refractory cases 7 . As a result of improvements in initial symptoms, we did not consider use of intravenous immunoglobulin of plasma exchange.…”

Section: Discussionmentioning

confidence: 99%

“…7 Intravenous immunoglobulin with doses ranging from 1 to 2 g/kg in 2-5 days or 400 mg/kg/day in 5 days or plasma exchange 3-7 cycles are commonly used in severe, life threatening or refractory cases. 7 As a result of improvements in initial symptoms, we did not consider use of intravenous immunoglobulin of plasma exchange. Third, relapse was observed after oral prednisone cessation.…”

Section: Discussionmentioning

confidence: 99%

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Myelin oligodendrocyte glycoprotein antibody‐associated disease presenting as recurrent acute disseminated encephalomyelitis: Case report of the youngest Mexican patient in the literature

García-Estrada

Gómez‐Figueroa

Morelos‐Cisneros

et al. 2022

Clinical & Exp Neuroim

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Background: Myelin oligodendrocyte glycoprotein antibody-associated disease myelin oligodendrocyte glycoprotein antibody-associated disease is an emerging demyelinating condition distinct from neuromyelitis optica spectrum disorder and multiple sclerosis affecting both children and adults with a spectrum of clinical manifestations ranging from optic neuritis, myelitis and acute disseminated encephalomyelitis.Case report: We describe the case of a 2 year-old girl diagnosed with myelin oligodendrocyte glycoprotein antibody-associated disease presenting as recurrent acute disseminated encephalomyelitis who showed suppression of disease activity after treatment with rituximab. This case represents the youngest Mexican patient with myelin oligodendrocyte glycoprotein antibody-associated disease reported to date.Conclusions: Information regarding the clinical presentation and evolution among different population could help to a better understanding of the presentation of this entity.

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Treatment of MOG-IgG associated disease in paediatric patients: A systematic review

Cited by 13 publications

References 19 publications

A Case of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease with Acute Bilateral Total Blindness

A Case of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease with Acute Bilateral Total Blindness

Clinical characteristic of myelin oligodendrocyte glycoprotein antibody associated cortical encephalitis in adults and outcomes following glucocorticoid therapy

Myelin oligodendrocyte glycoprotein antibody‐associated disease presenting as recurrent acute disseminated encephalomyelitis: Case report of the youngest Mexican patient in the literature

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