Clinical characteristics and associated factors of pediatric acute disseminated encephalomyelitis patients with MOG antibodies: a retrospective study in Hangzhou, China

Abstract Background: To investigate the clinical characteristics and associated factors of pediatric acute disseminated encephalomyelitis (ADEM) patients positive for anti-myelin oligodendrocyte glycoprotein (MOG) antibodies.Methods: This retrospective study included pediatric ADEM patients who underwent serum MOG antibody detection from May 2017 to August 2020. The patients were divided into two groups: those with (MOG+, n=35) and without (MOG−, n=50) anti-MOG antibodies in the serum. Our study analyzed the clinical characteristics of MOG-IgG-positive ADEM pediatric patients and conducted a comparative analysis between the two groups.Results: Thirty-five MOG-IgG-positive ADEM patients (21 males and 14 females) with encephalopathy, multifocal neurological symptoms, and typical magnetic resonance imaging (MRI) abnormalities were enrolled. They usually had a favorable outcome, while some suffered from relapse. Compared to the ADEM patients without MOG antibodies, MOG-IgG-positive ADEM patients suffered from a longer disease duration (median: 10 vs. 6 days), more meningeal involvement (31.4% vs. 8%) and frontal lobe involvement (82.8% vs. 68%), higher relapse rates (14.3% vs. 2%), lower serum tumor necrosis factor (1-12.4 pg/ml, median 1.7 vs. 1-34 pg/ml, median 2.2) and interferon-gamma (1-9.4 pg/ml, median 1.3 vs. 1-64 pg/ml, median 3) (all P < 0.05). Multivariate logistic regression analysis indicated that a longer disease duration, meningeal involvement, and frontal lobe involvement were associated factors for ADEM patients with MOG antibodies (P < 0.05).Conclusions: Our findings provide clinical evidence that a longer disease duration, meningeal involvement, and frontal lobe involvement are associated with pediatric MOG-IgG-positive ADEM.