Contributions
Abstract: P312
Type: Poster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Background and aims: A broad spectrum of central nervous system inflammatory disorders has been recognised related to anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs). We present clinical, MRI and cerebrospinal fluid (CSF) data of a patient cohort of anti-MOG-Abs positive Danish adults.
Methods: Case series: report of 16 patients. The serum analysis for anti-MOG Abs was performed by using a cell-based assay detecting antibodies of IgG1 class targeting full-length MOG in Oxford, UK.
Results: We have identified 7 female and 9 male with anti-MOG Abs between October 2015 and March 2017. The median age at onset was 33 (11-62). The mean follow-up was 92 (±70) months. Mean time to the second relapse was 25 (±23.6) months. Four patients had monophasic disease. The median number of relapses was 2.5 (range: 1-13). Frequent relapses (5-8-11-13) were observed in 4 cases, where the primary diagnosis was multiple sclerosis (MS) and disease modifying therapies were initiated. The clinical presentations included: optic neuritis in 5 cases; myelitis in 2 cases; optic neuritis and myelitis in 3 cases; myelitis and brainstem symptoms in 2 cases; optic neuritis and acute disseminated encephalomyelitis (ADEM) in 1 case; myelitis with ADEM in 1 case; combination of optic neuritis, myelitis and brainstem symptoms were observed in 2 cases. Brain MRI was repeatedly normal in 6 cases, but MS-like lesions in the corpus callosum and juxtacortical lesions were found in 3 cases. Spinal cord MRI showed longitudinally extensive spinal cord lesion in 9 cases. Furthermore, 4 patients had also short lesions in the spinal cord, and 4 patients had multiple lesions in the spinal cord. CSF revealed normal IgG-index in all 16 cases; only 2 patients out of 12 had oligoclonal bands (OCBs). Mononuclear pleocytosis was found in 9 cases with a median cell number 33.5 (1-195).
Conclusion: Our cohort represents a clinically heterogeneous patient population explaining the difficulty in establishing diagnosis. We observed a wide range of different MRI lesions characteristic to both neuromyelitis optica spectrum disorder and MS. The CSF results showed more clear difference from MS, and examination of anti-MOG-Abs should also be considered in MS cases without elevated IgG index and OCBs.
Disclosure:
Viktoria Papp has no disclosure.
Thor Petersen has received research grant support and travel support from Biogen Idec, Merck Serono, Novartis, Bayer Schering, Sanofi-Aventis, Roche, and Genzyme.
Jette L. Frederiksen has received no funding to support the presented work. She has served on scientific advisory boards for and received funding for travel related to these activities as well as honoraria from Biogen Idec, Merck Serono, Sanofi-Aventis, Teva, Novartis and Almirall. She has received speaker honoraria from Biogen Idec, Teva and Novartis. She has served as advisor on preclinical development for Takeda.
Melinda Magyari has served on scientific advisory board for Biogen Idec and Novartis, Merck, has received honoraria for lecturing from Biogen Idec, Merck, Novartis, Genzyme, has received support for congress participation from Biogen Idec, Novartis, Genzyme, Teva.
Zsolt Illes has served on scientific advisory boards, served as a consultant, received support for congress participation, received speaker honoraria, and received research support from Biogen, Merck-Serono, Sanofi-Genzyme, Lundbeck, and Novartis.
Finn Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, EMD Serono, Genzyme, Lundbeck, Merck, Novartis and Teva.
Abstract: P312
Type: Poster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Background and aims: A broad spectrum of central nervous system inflammatory disorders has been recognised related to anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs). We present clinical, MRI and cerebrospinal fluid (CSF) data of a patient cohort of anti-MOG-Abs positive Danish adults.
Methods: Case series: report of 16 patients. The serum analysis for anti-MOG Abs was performed by using a cell-based assay detecting antibodies of IgG1 class targeting full-length MOG in Oxford, UK.
Results: We have identified 7 female and 9 male with anti-MOG Abs between October 2015 and March 2017. The median age at onset was 33 (11-62). The mean follow-up was 92 (±70) months. Mean time to the second relapse was 25 (±23.6) months. Four patients had monophasic disease. The median number of relapses was 2.5 (range: 1-13). Frequent relapses (5-8-11-13) were observed in 4 cases, where the primary diagnosis was multiple sclerosis (MS) and disease modifying therapies were initiated. The clinical presentations included: optic neuritis in 5 cases; myelitis in 2 cases; optic neuritis and myelitis in 3 cases; myelitis and brainstem symptoms in 2 cases; optic neuritis and acute disseminated encephalomyelitis (ADEM) in 1 case; myelitis with ADEM in 1 case; combination of optic neuritis, myelitis and brainstem symptoms were observed in 2 cases. Brain MRI was repeatedly normal in 6 cases, but MS-like lesions in the corpus callosum and juxtacortical lesions were found in 3 cases. Spinal cord MRI showed longitudinally extensive spinal cord lesion in 9 cases. Furthermore, 4 patients had also short lesions in the spinal cord, and 4 patients had multiple lesions in the spinal cord. CSF revealed normal IgG-index in all 16 cases; only 2 patients out of 12 had oligoclonal bands (OCBs). Mononuclear pleocytosis was found in 9 cases with a median cell number 33.5 (1-195).
Conclusion: Our cohort represents a clinically heterogeneous patient population explaining the difficulty in establishing diagnosis. We observed a wide range of different MRI lesions characteristic to both neuromyelitis optica spectrum disorder and MS. The CSF results showed more clear difference from MS, and examination of anti-MOG-Abs should also be considered in MS cases without elevated IgG index and OCBs.
Disclosure:
Viktoria Papp has no disclosure.
Thor Petersen has received research grant support and travel support from Biogen Idec, Merck Serono, Novartis, Bayer Schering, Sanofi-Aventis, Roche, and Genzyme.
Jette L. Frederiksen has received no funding to support the presented work. She has served on scientific advisory boards for and received funding for travel related to these activities as well as honoraria from Biogen Idec, Merck Serono, Sanofi-Aventis, Teva, Novartis and Almirall. She has received speaker honoraria from Biogen Idec, Teva and Novartis. She has served as advisor on preclinical development for Takeda.
Melinda Magyari has served on scientific advisory board for Biogen Idec and Novartis, Merck, has received honoraria for lecturing from Biogen Idec, Merck, Novartis, Genzyme, has received support for congress participation from Biogen Idec, Novartis, Genzyme, Teva.
Zsolt Illes has served on scientific advisory boards, served as a consultant, received support for congress participation, received speaker honoraria, and received research support from Biogen, Merck-Serono, Sanofi-Genzyme, Lundbeck, and Novartis.
Finn Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, EMD Serono, Genzyme, Lundbeck, Merck, Novartis and Teva.