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Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case.
Pediatrics. 2016 May; 137(5)Ped

Abstract

Myelin oligodendrocyte glycoprotein (MOG) is a candidate target antigen in demyelinating central nervous system diseases, including acute disseminated encephalomyelitis (ADEM), neuromyelitis optica, and multiple sclerosis. It may give prognostic information regarding monophasic or recurrent course of the disease. MOG antibodies have been shown to be positive in high titers during the first episode of ADEM with rapidly decreasing to undetectable limits after recovery. However, persistent MOG antibodies are considered as a predicting factor for multiple sclerosis, optic neuritis relapses, and incomplete recovery of ADEM. Here we report a unique case with persistent MOG antibodies presented with multiphasic ADEM-like attacks. A 6-year-old girl was consulted with encephalopathy, gait disturbance, and oculomotor nerve palsy. Periventricular white matter lesions were seen on cranial magnetic resonance imaging studies. ADEM was diagnosed and treated with steroid. During follow-up, she experienced repeated episodes after steroid therapy termination. We were able to search MOG antibody at the ninth attack. The positivity of this antibody remained. It was thought to be associated with steroid-dependent course, and azathioprine and intravenous human immunoglobulin treatment were added. Patients with persistent MOG antibodies may benefit from addition of immunosuppressant agents, which may decrease the number of attacks.

Authors+Show Affiliations

Departments of Pediatric Neurology, and ipekkalafatcilar@gmail.com.Departments of Pediatric Neurology, and.Departments of Pediatric Neurology, and.Departments of Pediatric Neurology, and.Pediatric Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.Pediatric Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.Departments of Pediatric Neurology, and.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27244783

Citation

Polat, İpek, et al. "Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case." Pediatrics, vol. 137, no. 5, 2016.
Polat İ, Yiş U, Karaoğlu P, et al. Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case. Pediatrics. 2016;137(5).
Polat, İ., Yiş, U., Karaoğlu, P., Ayanoğlu, M., Öztürk, T., Güleryüz, H., & Kurul, S. H. (2016). Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case. Pediatrics, 137(5). https://doi.org/10.1542/peds.2015-1958
Polat İ, et al. Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case. Pediatrics. 2016;137(5) PubMed PMID: 27244783.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case. AU - Polat,İpek, AU - Yiş,Uluç, AU - Karaoğlu,Pakize, AU - Ayanoğlu,Muge, AU - Öztürk,Tülay, AU - Güleryüz,Handan, AU - Kurul,Semra Hız, PY - 2016/02/16/accepted PY - 2016/6/1/entrez PY - 2016/6/1/pubmed PY - 2017/6/1/medline JF - Pediatrics JO - Pediatrics VL - 137 IS - 5 N2 - Myelin oligodendrocyte glycoprotein (MOG) is a candidate target antigen in demyelinating central nervous system diseases, including acute disseminated encephalomyelitis (ADEM), neuromyelitis optica, and multiple sclerosis. It may give prognostic information regarding monophasic or recurrent course of the disease. MOG antibodies have been shown to be positive in high titers during the first episode of ADEM with rapidly decreasing to undetectable limits after recovery. However, persistent MOG antibodies are considered as a predicting factor for multiple sclerosis, optic neuritis relapses, and incomplete recovery of ADEM. Here we report a unique case with persistent MOG antibodies presented with multiphasic ADEM-like attacks. A 6-year-old girl was consulted with encephalopathy, gait disturbance, and oculomotor nerve palsy. Periventricular white matter lesions were seen on cranial magnetic resonance imaging studies. ADEM was diagnosed and treated with steroid. During follow-up, she experienced repeated episodes after steroid therapy termination. We were able to search MOG antibody at the ninth attack. The positivity of this antibody remained. It was thought to be associated with steroid-dependent course, and azathioprine and intravenous human immunoglobulin treatment were added. Patients with persistent MOG antibodies may benefit from addition of immunosuppressant agents, which may decrease the number of attacks. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/27244783/Myelin_Oligodendrocyte_Glycoprotein_Antibody_Persistency_in_a_Steroid_Dependent_ADEM_Case_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=27244783 DB - PRIME DP - Unbound Medicine ER -