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, 22 (3), 312-9

Antibodies to Myelin Oligodendrocyte Glycoprotein in Aquaporin 4 Antibody Seronegative Longitudinally Extensive Transverse Myelitis: Clinical and Prognostic Implications

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Antibodies to Myelin Oligodendrocyte Glycoprotein in Aquaporin 4 Antibody Seronegative Longitudinally Extensive Transverse Myelitis: Clinical and Prognostic Implications

Álvaro Cobo-Calvo et al. Mult Scler.

Abstract

Objective: We aimed to investigate the frequency and clinical significance of antibodies to myelin oligodendrocyte glycoprotein (MOG-abs) in patients who presented with a first episode of seronegative aquaporin 4 antibody (AQP4-ab) longitudinally extensive transverse myelitis (LETM).

Methods: Epidemiological, clinical, and paraclinical data of 56 patients from three European centres were analysed. Patients were retrospectively tested for MOG-abs and AQP4-abs, by cell-based assays.

Findings: Thirteen (23.2%) patients were MOG-ab positive. Among the 56 patients, six (10.7%) converted to neuromyelitis optica (NMO), one (1.8%) to multiple sclerosis (MS), nine (16.1%) had recurrent LETM, and 40 (71.4%) remained as monophasic LETM. Compared with seronegative patients, those with MOG-abs were younger (median: 32.5 vs 44 years; p=0.007), had cerebrospinal fluid pleocytosis more frequently (94% vs 45%, p=0.003) and had better outcome (median Expanded Disability Status Scale (EDSS) 2.0 vs 3.0, p=0.027). MOG-ab positive patients also showed an increase risk of optic neuritis relapse and NMO conversion (p=0.010).

Conclusion: Patients with MOG-abs in AQP4-ab seronegative LETM have clinical distinctive features, higher risk of optic neuritis relapses, and better outcome than patients seronegative.

Keywords: Longitudinally extensive transverse myelitis; aquaporin-4 antibody; multiple sclerosis; myelin oligodendrocyte glycoprotein; neuromyelitis optica.

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