Objective: To describe the clinical radiological spectrum, management and outcomes of pediatric myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD). Methods: Identifying patients with Central Nervous System (CNS) demyelination who tested positive for Myelin Oligodendrocyte Glycoprotein (MOG) antibodies in CSF and/or serum followed by retrospective and prospective medical record review. Results: 9 children (3 males, 6 females) were identified. The median age at presentation was 6years. Clinical presentation included acute encephalopathy, acute encephalitis mimicking HSV encephalitis, aseptic meningitis, cranial nerve palsies, optic neuritis and acute ataxia. Recurrent presentations manifested with different set of symptoms, being well in between the episodes. CSF pleocytosis was noted in 4/9 cases. Imaging showed ADEM like picture in 4/9, optic neuritis in 3/9, meningeal enhancement in 2/9 and an acute encephalitis like picture in 1. First line therapy with pulse methylprednisolone and/or Plasma Exchange showed response in 7/9 children. 1 needed second line therapy with Rituximab due to severe presentation and 1 had a relapsing remitting course needing combination therapy with rituximab, monthly IV Immunoglobulin and Mycophenolate mofetil. Discussion: Pediatric MOGAD can have varied clinical presentations. Majority of the patients have a favorable outcome needing only first line immunotherapy. Occasional patient may need second line immunotherapy.

Anjaly Nair
Al Jalila children's hospital
United Arab Emirates

Sukanya Vrushabhendra Nanjudaiah
Al Jalila children's hospital
United Arab Emirates

Samar Almuntaser
Al Jalila children's hospital
United Arab Emirates

Nidheesh Cheeyancheri Chencheri
Al jalila children's hospital
United Arab Emirates

Mohamed Babiker
Al Jalila children's hospital
United Arab Emirates

Ali Elisir Nasreldien
Al jalila children's hospital
United Arab Emirates

Pawan Subhash Kashyape
Al Jalila children's hospital
United Arab Emirates