Contributions
Abstract: P347
Type: Poster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Introduction: Acquired demyelinating syndromes (ADS) are a group of auto-immune mediated demyelinating disorders of the central nervous system in children. For a subgroup of children, the demyelinating event can be the first presentation of multiple sclerosis (MS). A nationwide, multicentre and prospective cohort study was initiated in the Netherlands in 2006, with a reported ADS incidence of 0.66/100.000 per year and an MS incidence of 0.15/100.000 per year in the period between 2007 and 2010. In this study, we give an update on the incidence and the long term follow-up of ADS in the Netherlands.
Methods: Children < 18 years old were eligible when presenting with a first attack of demyelination and were consecutively included from January 2006 to May 2017. Clinical data were collected at inclusion. Available serum was tested for anti-MOG antibodies (MOG-ab). Diagnoses were reviewed by an experienced team in consensus with the International Paediatric MS study group 2012 diagnostic criteria.
Results: Between 2011 and 2016, 154 ADS patients were identified. Of these, 52 were diagnosed with MS (34%). This results in a minimal ADS incidence of 0.74/100.000 per year and a minimal MS incidence of 0.25/100.000 per year in this period. From 2006 to 2017, a total of 256 ADS patients were identified. During follow-up (median 43 months, IQR 18.84-71.25), 147 patients (57.4%) were diagnosed with monophasic disease, 92 patients with MS (35.9%) and 17 patients (6.6%) with multiphasic disease other than MS. The last group consisted of 2 (11.8%) multiphasic disseminated encephalomyelitis, 6 (35.3%) acute disseminated encephalomyelitis followed by recurrent optic neuritis, 5 (29.4%) neuromyelitis optica spectrum disorders, 1 (5.9 %) multiphasic MOG-disease not further specified and 3 (17.6%) chronic relapsing inflammatory optic neuropathy.
MOG-ab were absent in MS patients, but present in about 26% of monophasic patients (18/52). In patients with multiphasic disease other than MS, 71.4% (5/7) were positive for MOG-ab. In 80 MS patients the EDSS score at follow-up was available (median follow-up time 56 months, IQR 32.0-73.75). EDSS score of 4.0 was reached in 4/80 patients (5%).
Conclusion: The incidence of ADS in children in the Netherlands has increased in the past few years, mainly due to an increase in the MS incidence.
Disclosure:
C. Louk de Mol: nothing to disclose
Yu Yi M. Wong: nothing to disclose
E. Daniëlle van Pelt: nothing to disclose
Immy A. Ketelslegers: nothing to disclose
Coriene E. Catsman-Berrevoets: nothing to disclose
Rogier Q. Hintzen: Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis
Rinze F. Neuteboom: nothing to disclose
Abstract: P347
Type: Poster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Introduction: Acquired demyelinating syndromes (ADS) are a group of auto-immune mediated demyelinating disorders of the central nervous system in children. For a subgroup of children, the demyelinating event can be the first presentation of multiple sclerosis (MS). A nationwide, multicentre and prospective cohort study was initiated in the Netherlands in 2006, with a reported ADS incidence of 0.66/100.000 per year and an MS incidence of 0.15/100.000 per year in the period between 2007 and 2010. In this study, we give an update on the incidence and the long term follow-up of ADS in the Netherlands.
Methods: Children < 18 years old were eligible when presenting with a first attack of demyelination and were consecutively included from January 2006 to May 2017. Clinical data were collected at inclusion. Available serum was tested for anti-MOG antibodies (MOG-ab). Diagnoses were reviewed by an experienced team in consensus with the International Paediatric MS study group 2012 diagnostic criteria.
Results: Between 2011 and 2016, 154 ADS patients were identified. Of these, 52 were diagnosed with MS (34%). This results in a minimal ADS incidence of 0.74/100.000 per year and a minimal MS incidence of 0.25/100.000 per year in this period. From 2006 to 2017, a total of 256 ADS patients were identified. During follow-up (median 43 months, IQR 18.84-71.25), 147 patients (57.4%) were diagnosed with monophasic disease, 92 patients with MS (35.9%) and 17 patients (6.6%) with multiphasic disease other than MS. The last group consisted of 2 (11.8%) multiphasic disseminated encephalomyelitis, 6 (35.3%) acute disseminated encephalomyelitis followed by recurrent optic neuritis, 5 (29.4%) neuromyelitis optica spectrum disorders, 1 (5.9 %) multiphasic MOG-disease not further specified and 3 (17.6%) chronic relapsing inflammatory optic neuropathy.
MOG-ab were absent in MS patients, but present in about 26% of monophasic patients (18/52). In patients with multiphasic disease other than MS, 71.4% (5/7) were positive for MOG-ab. In 80 MS patients the EDSS score at follow-up was available (median follow-up time 56 months, IQR 32.0-73.75). EDSS score of 4.0 was reached in 4/80 patients (5%).
Conclusion: The incidence of ADS in children in the Netherlands has increased in the past few years, mainly due to an increase in the MS incidence.
Disclosure:
C. Louk de Mol: nothing to disclose
Yu Yi M. Wong: nothing to disclose
E. Daniëlle van Pelt: nothing to disclose
Immy A. Ketelslegers: nothing to disclose
Coriene E. Catsman-Berrevoets: nothing to disclose
Rogier Q. Hintzen: Received honoraria for serving on advisory boards for Biogen Idec, Roche, Sanofi. He participated in trials with BiogenIdec, Merck-Serono, Roche, Genzyme and Novartis
Rinze F. Neuteboom: nothing to disclose