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2018 ; 4
(3
): 2055217318787829
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MOG-IgG-associated disease has a stereotypical clinical course, asymptomatic
visual impairment and good treatment response
#MMPMID30038790
Pandit L
; Mustafa S
; Nakashima I
; Takahashi T
; Kaneko K
Mult Scler J Exp Transl Clin
2018[Jul]; 4
(3
): 2055217318787829
PMID30038790
show ga
OBJECTIVES: We investigated the clinical characteristics and treatment response
in myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disease and
looked for evidence of subclinical disease. METHODS: We prospectively evaluated
the frequency and pattern of relapse, tested afferent visual function and
monitored treatment response in 42 south Asian patients from a single centre.
RESULTS: Eighteen patients (42.9%) had monophasic and 24 (57.1%) a relapsing
course. Disease duration was longer (P<0.02) in those with a relapsing course.
Median time to the second attack was prolonged (P<0.04) in patients with
recurrent transverse myelitis when compared with neuromyelitis optica spectrum
disorder and recurrent optic neuritis. Thirteen out of 17 patients (76.5%)
initially presenting with optic neuritis developed recurrent optic neuritis
later. After the first attack of transverse myelitis, 17 out of 22 (77.3%) had
disease confined to the spinal cord. Optical coherence tomography detected
peripapillary retinal nerve fibre layer thickness (P<0.05) and macular ganglion
cell complex volume (P<0.005) abnormalities in seven out of 10 (70.0%) patients
without clinical optic neuritis. Immunosuppressants induced remission in 17 out
of 22 (77.3%) patients during a median follow-up of 48 months and the median
Expanded Disability Status Score was 1 (range 1-10). CONCLUSION: Our study
highlighted the tendency for stereotypical attacks in MOG-IgG-associated disease,
heterogeneity in clinical course among subtypes, subclinical visual impairment
and the need for early and sustained immunosuppressive therapy.