Clinico-radiological spectrum of MOG antibody associated disorder (MOGAD) in Pediatric population.

Clinico-radiological spectrum of MOG antibody associated disorder (MOGAD) in Pediatric population.

Introduction: MOGAD is a type of CNS inflammatory disorder, characterized by CNS demyelination with presence of MOG antibodies. It has variable clinical presentation as optic neuritis, transverse myelitis, acute demyelinating encephalomyelitis and cortical encephalitis. Immunotherapy is the cornerstone of treatment.

Aim: To study the clinical and radiological spectrum of MOG antibody associated disorder.

Methodology: This is a retrospective study of patients of age <16 years and diagnosed with MOGAD based on serology. The demographic profile, age of onset of symptoms, clinical features, CSF studies, radiological findings, treatment and response to treatment were evaluated. All patients were treated with Inj. Methylprednisolone and oral steroids. The patients with no or minimal response, were given inj IVIG.

Results: The mean age of onset of disease is 6.2 ± 2.4 years, predominantly affecting girls (54.5%). The most common symptoms were fever (100%) and headache (45%). The most common clinical presentation was acute demyelinating encephalomyelitis (4/11) and optic neuritis (4/11) f/b acute encephalitis (2/11) and transverse myelitis (1/11). CSF studies showed high proteins (45.4%) and IgG level (54.5%). Most common MRI finding was demyelination predominantly involving subcortical and cortical white matter of frontal and parietal region. All patients responded to treatment, however two patients had relapses on follow up.

Conclusion: MOGAD is an immune-mediated encephalitis with female predominance. MRI shows demyelination in variable areas. There is good response to treatment with immunosuppressants.
Keywords: MOG, MOGAD, ENCEPHALITIS, DEMYELINATION, CNS INFLAMMATION