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Abstract
Objectives: To report an association of myelin-oligodendrocyte glycoprotein (MOG) antibodies with aquaporin-4 (AQP4) antibody–seronegative neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) in adults.
Methods: We describe the clinical and serologic features of 4 adult patients with an NMO/NMOSD phenotype who had antibodies to MOG.
Results: Twenty-seven adult AQP4-seronegative NMO/NMOSD patients were tested for MOG antibodies. Four patients (3 male, 1 female) with severe optic neuritis and/or longitudinally extensive transverse myelitis were positive. All 4 made good recoveries with steroids or plasma exchange. Two patients experienced recurrence of symptoms when corticosteroids were withdrawn quickly but none have experienced further relapses over a mean follow-up of 12 months, although 3 patients remain on treatment. Imaging abnormalities resolved fully following clinical recovery and MOG antibody titers fell in all 4 patients. MOG antibodies were not found in 44 AQP4 antibody–positive NMO/NMOSD patients, 75 adult patients with multiple sclerosis, or 47 healthy individuals.
Conclusions: MOG antibody–associated NMO/NMOSD could account for some cases thought previously to be AQP4-seronegative NMO/NMOSD. Our 4 patients appear to have more favorable clinical outcomes than those with typical AQP4 antibody–mediated disease. However, further studies of NMO/NMOSD and other demyelinating conditions are required to help clarify the diagnostic and prognostic relevance of MOG antibodies.
GLOSSARY
- ADEM=
- acute disseminated encephalomyelitis;
- AQP4 =
- aquaporin-4;
- AQP4-Abs =
- antibodies targeting aquaporin-4;
- MOG =
- myelin-oligodendrocyte glycoprotein;
- MOG-Abs =
- myelin-oligodendrocyte glycoprotein antibodies;
- MS =
- multiple sclerosis;
- NMO =
- neuromyelitis optica;
- NMOSD =
- neuromyelitis optica spectrum disorder;
- ON =
- optic neuritis;
- TM =
- transverse myelitis
- Received September 6, 2011.
- Accepted March 28, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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