Prognostic Factors in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Single Center Experience
Murat Kürtüncü1, Volkan Abaylı1, Tuncay Gündüz1, Mefküre Eraksoy1
1Neurology, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University
Objective:
We evaluated patients with MOG antibody disease (MOGAD) in terms of clinical and radiological features and tried to assess prognostic factors.
Background:
MOGAD is a neuro-inflammatory disease which is recognized as a separate demyelinating disease with specific clinical and paraclinical features. The differential diagnosis of MOGAD is notoriously difficult.
Design/Methods:
We retrospectively analyzed the clinical and radiological data of patients who were followed in the Department of Neurology, Istanbul University Faculty of Medicine. In our study, patients with a definite diagnosis of MOGAD were included. Patients were interviewed in the clinic or by phone, if necessary. Statistical evaluations were performed using independent-samples Mann Whitney U, Fisher exact, and log-rank tests.
Results:
MOG antibodies were requested for 495 patients, and 23 tests were positive. Twenty patients (male: 10, female: 10, median age at onset: 33 years (95% CI: 25-42) with a mean follow-up of 51 months (95% CI: 15-120) with a definite diagnosis of MOGAD were included in the study. The median time to second relapse in males was 7 months (95% CI: 2-11), and in females it was 32 months (95% CI: 14-49)(p=0.054).Cerebrospinal fluid analysis (CSF) was performed in 15 patients. Seven (46.6%) of them had pathological values. The time to the second attack in patients with an elevated CSF protein level tended to be shorter than in patients with a normal CSF protein level (91 vs. 12 months; p=0.063). Seventeen (85.0%) patients received high dose steroid treatment; 13 of them recovered completely, Most of the patients received azathioprine (16), others rituximab (3), IVIG (2), mycophenolate mofetil (4), and cyclophosphamide (2).
Conclusions:
Patients with MOGAD generally have a favorable prognosis. We observed frequent CSF OCBs in female patients. Additionally, the disease tends to have a worse prognosis in males. The disease tends to progress worse in patients with an elevated CSF protein.