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RELAPSING AQP4 ANTIBODY NEGATIVE NMO WITH MOG ANTIBODIES
  1. Liene Elsone1,
  2. Patrick Waters2,
  3. Mark Woodhall2,
  4. Kerry Mutch1,
  5. Anu Jacob1
  1. 1The Walton Centre NHS Foundation Trust
  2. 2Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford

Abstract

Introduction Around 70–90% of typical NMO have aquaporin-4 antibodies (AQP4-Ab). More recently, an association between myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) and monophasic NMO has been reported.

Methods We present 5 AQP4-Ab negative cases with relapsing CNS demyelinating disease (4 with NMO phenotype) associated with MOG-Ab.

Results All patients were Caucasian. Four patients presented with typical NMO phenotype. One patient had a long myelitis and a further brainstem event. Median age at onset was 17 (16–39) years. The first episode of optic neuritis and longitudinally extensive myelitis developed simultaneously in 2 patients while 2 patients had inter-attack interval 1.1 and 7 years. All except one patient had a normal brain MRI. EDSS (visual) scores after disease duration (number of relapses) of 1.3 (2), 1.6 (2), 3.4 (6), 8.3 (7) and 12 (13) years were 5 (0), 4 (3), 3 (5), 4 (0) and 4 (6) respectively.

Conclusions MOG-Ab can be seen in relapsing NMO and is not restricted to the monophasic subtype. The clinical and diagnostic role of MOG-Ab is still evolving.

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