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MOG encephalomyelitis: distinct clinical, MRI and CSF features in patients with longitudinal extensive transverse myelitis as first clinical presentation.
J Neurol. 2020 Jun; 267(6):1632-1642.JN

Abstract

BACKGROUND

Based on clinical, immunological and histopathological evidence, MOG-IgG-associated encephalomyelitis (MOG-EM) has emerged as a distinct disease entity different from multiple sclerosis (MS) and aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder (NMOSD). MOG-EM is associated with a broader clinical phenotype including optic neuritis, myelitis, brainstem lesions and acute disseminated encephalomyelitis with a substantial clinical and radiological overlap to other demyelinating CNS disorders.

OBJECTIVE

To evaluate common clinical, MRI and CSF findings, as well as therapy responses in patients with longitudinal extensive transverse myelitis (LETM) as initial clinical presentation of MOG-EM.

METHODS

After excluding patients with a known diagnosis of MS, we identified 153 patients with myelitis of which 7 fulfilled the inclusion criteria and were investigated for MRI, CSF and clinical parameters.

RESULTS

Patients with LETM as first clinical presentation of MOG-EM display similar characteristics, namely a lack of gadolinium-enhancement in spinal cord MRI, marked pleocytosis, negative oligoclonal bands, a previous history of infections/vaccinations and response to antibody-depleting treatments for acute attacks and long-term treatment.

CONCLUSIONS

We identify common pathological findings in patients with LETM as first clinical presentation of MOG-EM which distinguishes it from other forms of LETM and should lead to testing for MOG-IgG in these cases.

Authors+Show Affiliations

Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.Clinic of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.Clinic of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.Clinic of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany.Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany. Stefan.bittner@unimedizin-mainz.de.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32055995

Citation

Loos, Julia, et al. "MOG Encephalomyelitis: Distinct Clinical, MRI and CSF Features in Patients With Longitudinal Extensive Transverse Myelitis as First Clinical Presentation." Journal of Neurology, vol. 267, no. 6, 2020, pp. 1632-1642.
Loos J, Pfeuffer S, Pape K, et al. MOG encephalomyelitis: distinct clinical, MRI and CSF features in patients with longitudinal extensive transverse myelitis as first clinical presentation. J Neurol. 2020;267(6):1632-1642.
Loos, J., Pfeuffer, S., Pape, K., Ruck, T., Luessi, F., Spreer, A., Zipp, F., Meuth, S. G., & Bittner, S. (2020). MOG encephalomyelitis: distinct clinical, MRI and CSF features in patients with longitudinal extensive transverse myelitis as first clinical presentation. Journal of Neurology, 267(6), 1632-1642. https://doi.org/10.1007/s00415-020-09755-x
Loos J, et al. MOG Encephalomyelitis: Distinct Clinical, MRI and CSF Features in Patients With Longitudinal Extensive Transverse Myelitis as First Clinical Presentation. J Neurol. 2020;267(6):1632-1642. PubMed PMID: 32055995.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - MOG encephalomyelitis: distinct clinical, MRI and CSF features in patients with longitudinal extensive transverse myelitis as first clinical presentation. AU - Loos,Julia, AU - Pfeuffer,Steffen, AU - Pape,Katrin, AU - Ruck,Tobias, AU - Luessi,Felix, AU - Spreer,Annette, AU - Zipp,Frauke, AU - Meuth,Sven G, AU - Bittner,Stefan, Y1 - 2020/02/13/ PY - 2019/12/18/received PY - 2020/02/08/accepted PY - 2020/02/06/revised PY - 2020/2/15/pubmed PY - 2020/2/15/medline PY - 2020/2/15/entrez KW - Diagnosis KW - Longitudinal extensive transverse myelitis (LETM) KW - Myelin oligodendrocyte glycoprotein (MOG) antibodies KW - Myelitis KW - Neuromyelitis optica spectrum disorders (NMOSD) SP - 1632 EP - 1642 JF - Journal of neurology JO - J. Neurol. VL - 267 IS - 6 N2 - BACKGROUND: Based on clinical, immunological and histopathological evidence, MOG-IgG-associated encephalomyelitis (MOG-EM) has emerged as a distinct disease entity different from multiple sclerosis (MS) and aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder (NMOSD). MOG-EM is associated with a broader clinical phenotype including optic neuritis, myelitis, brainstem lesions and acute disseminated encephalomyelitis with a substantial clinical and radiological overlap to other demyelinating CNS disorders. OBJECTIVE: To evaluate common clinical, MRI and CSF findings, as well as therapy responses in patients with longitudinal extensive transverse myelitis (LETM) as initial clinical presentation of MOG-EM. METHODS: After excluding patients with a known diagnosis of MS, we identified 153 patients with myelitis of which 7 fulfilled the inclusion criteria and were investigated for MRI, CSF and clinical parameters. RESULTS: Patients with LETM as first clinical presentation of MOG-EM display similar characteristics, namely a lack of gadolinium-enhancement in spinal cord MRI, marked pleocytosis, negative oligoclonal bands, a previous history of infections/vaccinations and response to antibody-depleting treatments for acute attacks and long-term treatment. CONCLUSIONS: We identify common pathological findings in patients with LETM as first clinical presentation of MOG-EM which distinguishes it from other forms of LETM and should lead to testing for MOG-IgG in these cases. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/32055995/MOG_encephalomyelitis:_distinct_clinical_MRI_and_CSF_features_in_patients_with_longitudinal_extensive_transverse_myelitis_as_first_clinical_presentation_ L2 - https://dx.doi.org/10.1007/s00415-020-09755-x DB - PRIME DP - Unbound Medicine ER -
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