Impact of Anti-MOG Antibody in Diagnosis of Autoimmune Diseases of the Central Nervous System in Children: A Case Series.

Abstract

Autoimmune diseases of the central nervous system in children present a significant diagnostic challenge due to their heterogeneous nature. The identification of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies has contributed to our understanding and classification of these disorders.This study aims to characterize the clinical, paraclinical, and neuroimaging findings in pediatric patients diagnosed with acquired demyelinating syndromes (ADS) and autoimmune encephalitis (AE).Conducted as a descriptive case series, this study retrospectively analyzed medical records of children under 18 years diagnosed with ADS or AE from January 2017 to February 2022. We employed basic descriptive statistics to analyze patient demographics, clinical presentations, laboratory findings, and neuroimaging results.A total of 71 cases were evaluated, with 80% classified as ADS and 20% as AE. Within ADS, acute disseminated encephalomyelitis and optic neuritis were the most prevalent at 19%, followed by pediatric-onset multiple sclerosis at 17%, and transverse myelitis at 16%. AE cases were predominantly seropositive (93%), with a vast majority (92%) showing anti-NMDAR antibodies compared with 8% with anti-MOG antibodies. Since MOG antibody measurement became available at our institution in 2020, many new cases have been diagnosed as MOGAD (MOG antibody-associated disease), a new entity with different clinical manifestations.In children demyelinating disorders are more frequent than autoimmune encephalitis. New biomarkers, such as anti-MOG antibodies, have led to a better understanding of pediatric autoimmune CNS diseases. The study underscores the necessity of continuous reevaluation of diagnostic criteria and treatment protocols considering emerging biomarkers in neuroimmunology.