Incidence of pediatric neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease in Denmark 2008‒2018: A nationwide, population-based cohort study.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 31 03 2019
revised: 08 05 2019
accepted: 03 06 2019
pubmed: 6 7 2019
medline: 14 1 2020
entrez: 6 7 2019
Statut: ppublish

Résumé

The incidence of pediatric neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease have not been reported previously. Our aim was to estimate the incidence of pediatric NMOSD and the occurrence of anti-MOG antibody-associated disease in Denmark during 2008-18, and to evaluate the diagnostic usefulness of antibodies against MOG and aquaporin-4 (AQP4) in children <18 years. We undertook a nationwide, population-based, multicenter cohort study using data from the Danish National Patient Register, the Danish Multiple Sclerosis Registry, and laboratories providing anti-AQP4 and anti-MOG antibody analyses. Diagnoses were confirmed by review of the medical records, including blinded MRI review in most children with acute disseminated encephalomyelitis (ADEM). In children with acquired demyelinating syndromes, anti-AQP4 antibodies were detected in 4% and anti-MOG antibodies in 18%, including in the two children with ADEM who relapsed. We identified four children with NMOSD, equivalent to an incidence of 0.031/100,000 (95% confidence interval = 0.011‒0.082). In anti-MOG antibody-positive children, 32% relapsed during follow-up. Pediatric NMOSD and MOG antibody-associated disease are rare, but one-third of anti-MOG-positive children relapsed. In pediatric ADEM, only anti-MOG antibody-positive children relapsed, but the overall risk of relapse after pediatric ADEM was low.

Sections du résumé

BACKGROUND BACKGROUND
The incidence of pediatric neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease have not been reported previously. Our aim was to estimate the incidence of pediatric NMOSD and the occurrence of anti-MOG antibody-associated disease in Denmark during 2008-18, and to evaluate the diagnostic usefulness of antibodies against MOG and aquaporin-4 (AQP4) in children <18 years.
METHODS METHODS
We undertook a nationwide, population-based, multicenter cohort study using data from the Danish National Patient Register, the Danish Multiple Sclerosis Registry, and laboratories providing anti-AQP4 and anti-MOG antibody analyses. Diagnoses were confirmed by review of the medical records, including blinded MRI review in most children with acute disseminated encephalomyelitis (ADEM).
RESULTS RESULTS
In children with acquired demyelinating syndromes, anti-AQP4 antibodies were detected in 4% and anti-MOG antibodies in 18%, including in the two children with ADEM who relapsed. We identified four children with NMOSD, equivalent to an incidence of 0.031/100,000 (95% confidence interval = 0.011‒0.082). In anti-MOG antibody-positive children, 32% relapsed during follow-up.
CONCLUSIONS CONCLUSIONS
Pediatric NMOSD and MOG antibody-associated disease are rare, but one-third of anti-MOG-positive children relapsed. In pediatric ADEM, only anti-MOG antibody-positive children relapsed, but the overall risk of relapse after pediatric ADEM was low.

Identifiants

pubmed: 31276927
pii: S2211-0348(19)30235-4
doi: 10.1016/j.msard.2019.06.002
pii:
doi:

Substances chimiques

Autoantibodies 0
Autoantigens 0
MOG protein, human 0
Myelin-Oligodendrocyte Glycoprotein 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

162-167

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Magnus S Boesen (MS)

Department of Pediatrics, Rigshospitalet, University of Copenhagen, Denmark; Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology, Herlev Hospital, Denmark. Electronic address: magnus.spangsberg.boesen@regionh.dk.

Poul E H Jensen (PEH)

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark.

Alfred P Born (AP)

Department of Pediatrics, Rigshospitalet, University of Copenhagen, Denmark.

Melinda Magyari (M)

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; Danish Multiple Sclerosis Registry, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark.

Anna C Nilsson (AC)

Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.

Christina Hoei-Hansen (C)

Department of Pediatrics, Rigshospitalet, University of Copenhagen, Denmark.

Morten Blinkenberg (M)

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark.

Finn Sellebjerg (F)

Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark.

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Classifications MeSH