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Abstract Details

Clinical Features of Children with MOG-IgG Who Fulfill Criteria of Multiple Sclerosis and Overlapping Disorders
Multiple Sclerosis
S3 - Multiple Sclerosis: Clinical Trials (2:24 PM-2:36 PM)
008
The 2023 MOGAD criteria have shown high accuracy in pediatric and adult patient populations, but for those who simultaneously meet criteria for MOGAD and multiple sclerosis (MS) the differential diagnosis remains challenging. The clinical significance and outcomes of pediatric patients in this clinical scenario are unclear.
To assess the clinical features, disease-modifying treatment response, and outcomes of children with MOG-IgG who fulfilled the 2017 McDonald criteria for MS
This prospective observational nationwide study included children (<18 years old) with a suspected acute demyelinating syndrome (ADS) whose serum or CSF was positive for MOG-IgG using a live cell-based assay, met the McDonald 2017 criteria, and had ≥ 1 year of clinical follow-up. We assessed clinical and radiological features at onset, during relapses, and treatment response.
Among a cohort of 554 children with confirmed ADS (196 with MOG-IgG), 8 patients (median age 11 years, IQR 9-14) harbored MOG-IgG antibodies and met criteria for MS: 2 had clinical-radiological features of MS and are no longer discussed here, and 6 of overlapping MOGAD-MS. Of these six, five presented with typical MOGAD manifestations (3 had bilateral optic neuritis, 1 cortical encephalitis, 1 brainstem-cerebellar syndrome), and four of them had specific CSF oligoclonal bands (CSF-OCB). The remaining patient had short myelitis; well-delimited brain MRI lesions, MOG-IgG restricted to CSF, negative CSF-OCB, and developed an early relapse of bilateral optic neuritis. All 6 patients had persistent silent radiological activity with lesional location and morphology suggestive of MS-like features, leading to initiation of disease modifying treatments (DMT). Although MS treatments were safe and effective, 5/6 (83%) patients eventually required high efficacy DMT.
About 4% of patients with MOG-IgG met MS criteria. The clinical-radiological spectrum ranged from typical MS to overlapping features between both entities. Patients usually required high efficacy DMT.
Authors/Disclosures
Elianet Fonseca, PhD (NOVARTIS)
PRESENTER 		Dr. Fonseca has nothing to disclose.
Gemma Olivé, MD Dr. Olivé has nothing to disclose.
Li-Wen Chen, MD, PhD Dr. Chen has received research support from National Cheng Kung University Hospital.
Fernando Paredes-Carmona, Sr., MD Mr. Paredes-Carmona has nothing to disclose.
NOEMI N. ENAMORADO, PhD Mrs. ENAMORADO has nothing to disclose.
Sabas Boyero Sabas Boyero has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Sabas Boyero has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Sabas Boyero has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Sabas Boyero has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Maria Del Mar Mendibe Bilbao No disclosure on file
Núria Visa-Reñé, MD Dr. Visa-Reñé has nothing to disclose.
Maria V. Lopez, MD, PhD Dr. lopez has nothing to disclose.
Ana Felipe, MD Dr. Felipe has nothing to disclose.
Gemma Romeu Cerrillos, MD Dr. Romeu Cerrillos has nothing to disclose.
Eugenia Martinez-Hernandez, MD (Hospital Clinic Barcelona) Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. The institution of Dr. Martinez-Hernandez has received research support from Instituto de Salud Carlos III. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with Sanofi. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings and speaker honoraria with UCB. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a speaker honoraria with Alexion. Dr. Martinez-Hernandez has received personal compensation in the range of $0-$499 for serving as a speaker honoraria with Terumo. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with Janssen. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with CSL Behring.
Yolanda Blanco Morgado, MD Dr. Blanco Morgado has nothing to disclose.
Maria Sepúlveda No disclosure on file
Albert Saiz (Hospital Clinico De Barcelona) Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janseen. Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for novartis. Albert Saiz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
Josep O. Dalmau, MD, PhD, FAAN Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astellas Research Institute of America. Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Research & Development . Dr. Dalmau has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. An immediate family member of Dr. Dalmau has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Dalmau has received research support from Sage Therapeutics. The institution of Dr. Dalmau has received research support from Edmond J.Safra Foundation . The institution of Dr. Dalmau has received research support from La Caixa Foundation. The institution of Dr. Dalmau has received research support from Spanish Ministry of Health (ISCIII). The institution of Dr. Dalmau has received research support from Euroimmun, Inc. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care.
Thais Armangue, MD (IDIBAPS-HClinic) Dr. Armangue has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. The institution of Dr. Armangue has received research support from ISCIII(Spanish institute of health) -PI21/00316, Marato TV3, La Caixa Research Foundadion, Pablove Foundation (689368), Torrons Vicens Foundation (PFNR0144), 2021 Invest AEP.