The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis
Purpose: To evaluate the clinical differences between pediatric and adult patients with myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis (MOG-EM).Methods: We retrospectively reviewed the clinical features of pediatric and adult patients with MOG-EM in our center between Nove...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-05-01
|
Series: | Frontiers in Neurology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.679430/full |
id |
doaj-ad36662f05954bd6a9df2718aecc5fef |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jie Xu Jie Xu Lingjuan Liu Lingjuan Liu Jie Xiong Jie Xiong Lu Zhang Lu Zhang Peng Huang Peng Huang Li Tang Li Tang Yangyang Xiao Yangyang Xiao Xingfang Li Xingfang Li Jian Li Jian Li Yingying Luo Huiling Li Dingan Mao Dingan Mao Liqun Liu Liqun Liu |
spellingShingle |
Jie Xu Jie Xu Lingjuan Liu Lingjuan Liu Jie Xiong Jie Xiong Lu Zhang Lu Zhang Peng Huang Peng Huang Li Tang Li Tang Yangyang Xiao Yangyang Xiao Xingfang Li Xingfang Li Jian Li Jian Li Yingying Luo Huiling Li Dingan Mao Dingan Mao Liqun Liu Liqun Liu The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis Frontiers in Neurology myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis demyelinating disease optic neuritis pediatrics adults |
author_facet |
Jie Xu Jie Xu Lingjuan Liu Lingjuan Liu Jie Xiong Jie Xiong Lu Zhang Lu Zhang Peng Huang Peng Huang Li Tang Li Tang Yangyang Xiao Yangyang Xiao Xingfang Li Xingfang Li Jian Li Jian Li Yingying Luo Huiling Li Dingan Mao Dingan Mao Liqun Liu Liqun Liu |
author_sort |
Jie Xu |
title |
The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis |
title_short |
The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis |
title_full |
The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis |
title_fullStr |
The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis |
title_full_unstemmed |
The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis |
title_sort |
clinical, radiologic, and prognostic differences between pediatric and adult patients with myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2021-05-01 |
description |
Purpose: To evaluate the clinical differences between pediatric and adult patients with myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis (MOG-EM).Methods: We retrospectively reviewed the clinical features of pediatric and adult patients with MOG-EM in our center between November 2015 and October 2020.Results: Twenty-eight pediatric patients and 25 adults were admitted to our study. Bilateral optic neuritis (BON) was the most common initial phenotype in the pediatric group but less common in the adult group (28.57 vs. 0%, p = 0.0119). Almost half of the adult patients presented with neuromyelitis optica spectrum disease (NMOSD), which was less prevalent among the pediatrics (48 vs. 21.43%, p = 0.0414). Visual impairment was the most common symptom in both groups during the initial attack (pediatric group, 39.29%; adult group, 64%) and throughout the full course (pediatric group, 57.14%; adult group, 72%). More pediatric patients suffered from fever than adult patients at onset (pediatric group, 28.57%; adult group, 4%; p = 0.0442) and throughout the full course (pediatric group, 39.29%; adult group, 12%; p = 0.0245). Multiple patchy lesions in subcortical white matter (pediatric group, 40.74%; adult group, 45%), periventricular (pediatric group, 25.93%; adult group, 35%), infratentorial (pediatric group, 18.52%; adult group, 30%) and deep gray matter (pediatric group, 25.93%; adult group, 20%) were frequent in all cases, no significant difference was found between the two groups, while bilateral optic nerve involvement was more frequent in pediatric group (61.54 vs. 14.29%, p = 0.0042) and unilateral optic nerve involvement was higher in adult group (64.29 vs. 15.38%, p = 0.0052). At the last follow-up, adult patients had a higher average EDSS score (median 1.0, range 0–3) than pediatrics (median 0.0, range 0–3), though not significant (p = 0.0752). Patients aged 0–9 years (61.54%) and 10–18 years (70%), and patients presenting with encephalitis/meningoencephalitis (100%) and ADEM (75%) were more likely to recover fully.Conclusions: Visual impairment was the dominant symptom in both pediatric and adult patients, while fever was more frequent in pediatric patients. Data suggested that BON and bilateral optic nerve involvement were more common in pediatric cases whereas NMOSD and unilateral optic nerve involvement were more prevalent in adults. The younger patients and patients presenting with encephalitis/meningoencephalitis and ADEM tended to recover better. |
topic |
myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis demyelinating disease optic neuritis pediatrics adults |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2021.679430/full |
work_keys_str_mv |
AT jiexu theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexu theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT lingjuanliu theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT lingjuanliu theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexiong theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexiong theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT luzhang theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT luzhang theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT penghuang theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT penghuang theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT litang theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT litang theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT yangyangxiao theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT yangyangxiao theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT xingfangli theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT xingfangli theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jianli theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jianli theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT yingyingluo theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT huilingli theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT dinganmao theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT dinganmao theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT liqunliu theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT liqunliu theclinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexu clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexu clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT lingjuanliu clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT lingjuanliu clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexiong clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jiexiong clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT luzhang clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT luzhang clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT penghuang clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT penghuang clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT litang clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT litang clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT yangyangxiao clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT yangyangxiao clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT xingfangli clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT xingfangli clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jianli clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT jianli clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT yingyingluo clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT huilingli clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT dinganmao clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT dinganmao clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT liqunliu clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis AT liqunliu clinicalradiologicandprognosticdifferencesbetweenpediatricandadultpatientswithmyelinoligodendrocyteglycoproteinantibodyassociatedencephalomyelitis |
_version_ |
1721435997616472064 |
spelling |
doaj-ad36662f05954bd6a9df2718aecc5fef2021-05-20T06:29:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-05-011210.3389/fneur.2021.679430679430The Clinical, Radiologic, and Prognostic Differences Between Pediatric and Adult Patients With Myelin Oligodendrocyte Glycoprotein Antibody-Associated EncephalomyelitisJie Xu0Jie Xu1Lingjuan Liu2Lingjuan Liu3Jie Xiong4Jie Xiong5Lu Zhang6Lu Zhang7Peng Huang8Peng Huang9Li Tang10Li Tang11Yangyang Xiao12Yangyang Xiao13Xingfang Li14Xingfang Li15Jian Li16Jian Li17Yingying Luo18Huiling Li19Dingan Mao20Dingan Mao21Liqun Liu22Liqun Liu23Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Neurology, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, ChinaChildren's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital, Central South University, Changsha, ChinaPurpose: To evaluate the clinical differences between pediatric and adult patients with myelin oligodendrocyte glycoprotein antibody-associated encephalomyelitis (MOG-EM).Methods: We retrospectively reviewed the clinical features of pediatric and adult patients with MOG-EM in our center between November 2015 and October 2020.Results: Twenty-eight pediatric patients and 25 adults were admitted to our study. Bilateral optic neuritis (BON) was the most common initial phenotype in the pediatric group but less common in the adult group (28.57 vs. 0%, p = 0.0119). Almost half of the adult patients presented with neuromyelitis optica spectrum disease (NMOSD), which was less prevalent among the pediatrics (48 vs. 21.43%, p = 0.0414). Visual impairment was the most common symptom in both groups during the initial attack (pediatric group, 39.29%; adult group, 64%) and throughout the full course (pediatric group, 57.14%; adult group, 72%). More pediatric patients suffered from fever than adult patients at onset (pediatric group, 28.57%; adult group, 4%; p = 0.0442) and throughout the full course (pediatric group, 39.29%; adult group, 12%; p = 0.0245). Multiple patchy lesions in subcortical white matter (pediatric group, 40.74%; adult group, 45%), periventricular (pediatric group, 25.93%; adult group, 35%), infratentorial (pediatric group, 18.52%; adult group, 30%) and deep gray matter (pediatric group, 25.93%; adult group, 20%) were frequent in all cases, no significant difference was found between the two groups, while bilateral optic nerve involvement was more frequent in pediatric group (61.54 vs. 14.29%, p = 0.0042) and unilateral optic nerve involvement was higher in adult group (64.29 vs. 15.38%, p = 0.0052). At the last follow-up, adult patients had a higher average EDSS score (median 1.0, range 0–3) than pediatrics (median 0.0, range 0–3), though not significant (p = 0.0752). Patients aged 0–9 years (61.54%) and 10–18 years (70%), and patients presenting with encephalitis/meningoencephalitis (100%) and ADEM (75%) were more likely to recover fully.Conclusions: Visual impairment was the dominant symptom in both pediatric and adult patients, while fever was more frequent in pediatric patients. Data suggested that BON and bilateral optic nerve involvement were more common in pediatric cases whereas NMOSD and unilateral optic nerve involvement were more prevalent in adults. The younger patients and patients presenting with encephalitis/meningoencephalitis and ADEM tended to recover better.https://www.frontiersin.org/articles/10.3389/fneur.2021.679430/fullmyelin oligodendrocyte glycoprotein antibody-associated encephalomyelitisdemyelinating diseaseoptic neuritispediatricsadults |