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MOG-IGG IN NMO AND NMO-LIKE DISORDERS
  1. Sebastian Luppe1,2,
  2. Patrick Waters3,
  3. Angela Vincent3,
  4. Neil Robertson1,2
  1. 1University Hospital of Wales
  2. 2Cardiff University
  3. 3Nuffield Department of Clinical Neurosciences, Oxford University

Abstract

40% of patients with an NMO-phenotype are seronegative for AQP4-IgG. Recent reports of antibodies against myelin-oligodendrocyte-glycoprotein(MOG) in NMO suggest an independent MOG-IgG disease. We compare the disease course, treatment and paraclinical results of 6 MOG-IgG+ vs. 41 AQP4+ patients.

We collected serum and clinical information from 67 patients with NMO phenotypes. Serum samples were analysed for AQP4-IgG and MOG-IgG.

4F,2M patients were MOG-IgG+ [32F:2M AQP4-IgG+]; none were positive for both antibodies. Mean-age-at-onset 27.6 years(14.7–45.6) MOG-IgG+ [41.6 yrs (3.8–77.2) AQP4-IgG+], mean disease duration 7.7 years (1.7–21.3) MOG-IgG+ [8.6 years (2.0–32.4) AQP4+], mean annualized relapse rate 0.7 (0.6–1.1)MOG-IgG [0.8 (0.1–2.3) AQP4-IgG+]. Mean EDSS at last follow-up was 3.0 (1.5–4.0) MOG-IgG+ [5.2 (1.5–8.0) AQP4-IgG+].

Patients with MOG-IgG+ related CNS disease exhibited a relapsing disease course and although recovery from repeated episodes of ON and LEM appears better than in AQP4-IgG+ disease, patients remain at risk of significant long-term disability.

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