Objectives: To present demographic, clinical, laboratory and prognostic data in a large group of children with ADEM and to investigate the role of anti-MOG antibodies in clinical findings and outcome.
Methods: ADEM patients (n=245) from 24 centers diagnosed in 2010-2021were retrospectively evaluated with descriptive statistics. Duplicate cases were excluded.
Results: The male/female ratio was 1.66:1, mean age at diagnosis was 6.33.8 (0.5-17.7) years. The most common findings on admission besides altered state of consciousness were fatigue (57.1%), headache (40.4%), and fever (39.6%). Serum anti-MOG antibodies were tested in 84 patients and 27 (32%) found positive by cell-based assay. Anti-MOG-positive patients were younger (5.12.7 vs. 7.13.4) and their blood white blood cell count was higher (15,1006,116/mm3 vs. 12,1685,830/mm3). Twenty-three (9.4%) patients had relapses. The final diagnoses and their anti-MOG antibody status is given in Table-1. Anti-MOG antibody positivity was not associated with need for intensive care unit, relapse, or recovery. Among the 172 patients with at least one-year follow-up, Glasgow Coma Score <10, need for intensive care unit, mechanical ventilation, and the presence of seizures on admission were associated with incomplete recovery [Modified Rankin Score (mRS)1 (n=26), epilepsy (n=20), (p<0.005)]. Only three patients (1,7%) remained dependent [mRS=3 (n=1), mRS=4 (n=2)] at one-year of follow-up.
Conclusion: ADEM is usually monophasic with relapses in 10% of the patients. The overall prognosis is good, regardless of the anti-MOG antibody status. The clinical condition on admission appeared as the most important prognostic factor.
Seda Kanmaz
Ege University Medical Faculty
Turkey
Sanem Yilmaz
Ege University Medical Faculty
Turkey
Nihal Olgac Dündar
Izmir Katip Celebi University Faculty of Medicine
Turkey
Ayse Aksoy
Ondokuz Mayis University Medical Faculty
Turkey
Mehmet Canpolat
Erciyes University Medical Faculty
Turkey
Huseyin Per
Erciyes University Medical Faculty
Turkey
Ilknur Erol
Baskent University Faculty of Medicine, Adana Dr.Turgut Noyan Application and Research Center
Turkey
Hakan Gumus
Erciyes University Medical Faculty
Turkey
Yasemin Ozkale
Baskent University Faculty of Medicine, Adana Dr.Turgut Noyan Application and Research Center
Turkey
Selcan Ozturk
Erciyes University Medical Faculty
Turkey
Dilara Ece Toprak
Ege University Medical Faculty
Turkey
Ibrahim Oncel
Hacettepe University Medical Faculty
Turkey
Murat Ozkale
Baskent University Faculty of Medicine, Adana Dr.Turgut Noyan Application and Research Center
Turkey
Elif Nurdan Mansur
Erciyes University Medical Faculty
Turkey
Hepsen Mine Serin
Ege University Medical Faculty
Turkey
Gulsen Ersoz
Hacettepe University Medical Faculty
Turkey
Seyda Besen
Baskent University Faculty of Medicine, Adana Dr.Turgut Noyan Application and Research Center
Turkey
Gulen Gul Mert
Cukurova University Medical Faculty
Turkey
Ayten Gulec
Erciyes University Medical Faculty
Turkey
Sevim Sahin
Karadeniz Technical University Medical Faculty
Turkey
Cemile Busra Olculu
Ege University Medical Faculty
Turkey
Ayberk Selek
Hacettepe University Medical Faculty
Turkey
Serdar Pekuz
University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital
Turkey
Gunce Basarir
University of Health Sciences Tepecik Training and Research Hospital
Turkey
Cagatay Gunay
Dokuz Eylul University Medical Faculty
Turkey
Leman Tekin Orgun
Baskent University Faculty of Medicine, Adana Dr.Turgut Noyan Application and Research Center
Turkey
Didem Bİcer
Cukurova University Medical Faculty
Turkey
Zehra Filiz Kahraman
Erciyes University Medical Faculty
Turkey
Deniz Yuksel
University of Health Sciences Turkey, Dr. Sami Ulus Research and Training Hospital
Turkey
Meral Karadag
Inonu University Medical Faculty
Turkey
Erdem Simsek
Ege University Medical Faculty
Turkey
Aycan Unalp
University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital
Turkey
Nihal Yildiz
Karadeniz Technical University Medical Faculty
Turkey
Meltem Cobanogullari Direk
Mersin University Medical Faculty
Turkey
Uluc Yis
Dokuz Eylul University Medical Faculty
Turkey
Huseyin Tan
Ataturk University Medical Faculty
Turkey
Cengiz Havali
Bursa Yuksek İhtisas Training and Research Hospital
Turkey
Aydan Degerliyurt
Turkey
Mesut Gungor
Kocaeli University Medical Faculty
Turkey
Ozlem Herguner
Cukurova University Medical Faculty
Turkey
Elif Perihan Oncel
Baskent University Faculty of Medicine, Adana Dr.Turgut Noyan Application and Research Center
Turkey
Olcay Unver
Marmara University Medical Faculty
Turkey
Hale Atalay Celik
University of Health Sciences Turkey, Dr. Sami Ulus Research and Training Hospital
Turkey
Bilge Ozgor
Inonu University Medical Faculty
Turkey
Ali Cansu
Karadeniz Technical University Medical Faculty
Turkey
Asli Kubra Atasever
Celal Bayar University Medical Faculty
Turkey
Ayse Tosun
Adnan Menderes University Medical Faculty
Turkey
Olcay Gungor
Pamukkale University Medical Faculty
Turkey
Cetin Okuyaz
Mersin University Medical Faculty
Turkey
Selvinaz Edizer
Bezm-i Alem Vakif University Medical Faculty
Turkey
Semra Hız
Dokuz Eylul University Medical Faculty
Turkey
Esra Sarıgecili
Adana City Training and Research Hospital
Turkey
Gokcen Oz Tuncer
Ondokuz Mayis University Medical Faculty
Turkey
Pinar Gencpinar
Izmir Katip Celebi University Faculty of Medicine
Turkey
Unsal Yilmaz
University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital
Turkey
Hasan Tekgul
Ege University Medical Faculty
Turkey
Banu Anlar
Hacettepe University Medical Faculty
Turkey
