儿童抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病急性期视觉诱发电位特点分析

doi:10.12372/jcp.2022.21e1251

Abstract

Abstract: Objective To investigate the characteristics of visual evoked potentials (VEP) in children with MOG-IgG associated disorders (MOGAD) in the acute phase.Methods The clinical data of children admitted from May 2018 to February 2020 who were clinically diagnosed with central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDDs) were retrospectively analyzed. The children were divided into different groups according to the results of serum MOG-antibody detection and whether the optic nerve was involved clinically. The characteristics of VEP between different groups were analyzed.Results Among 67 children with CNS-IIDDS, 29 (43.3%) were in the MOG antibody positive group, and 15 (51.7%) had optic neuritis. There were 38 (56.7%) children in the MOG antibody negative group, and 19 (50.0%) had optic neuritis. The VEP test was examined on both eyes of all children, including 58 eyes in the MOG antibody positive group and 76 eyes in the MOG antibody negative group, obtaining VEP results of 134 eyes in total. Among the 66 eyes in the non-optic neuritis group, the abnormal rate of VEP in the MOG antibody positive group (14/28, 50.0%) was significantly higher than that in the MOG antibody negative group (9/38, 23.7%), and the difference was statistically significant (P<0.05). In the 68 eyes of the optic neuritis group, the proportion of blindness and severe vision impairment in the MOG antibody positive group was higher than that in the MOG antibody seronegative group, and the difference was statistically significant (P<0.05). In 58 eyes of MOG antibody positive group, there was significant difference in the abnormal rate of VEP between groups with different MOG antibody titer (P<0.05). The abnormal rate of VEP increased with the increase of MOG antibody titer.Conclusions VEP can effectively detect subclinical lesions of optic nerve in MOGAD. The probability of visual pathway damage may be higher under the conditions of high MOG antibody titers.

Key words: myelin oligodendrocyte glycoprotein, myelin oligodendrocyte glycoprotein immunoglobulin G associated disorders, visual evoked potential, optic neuritis, child

CHEN Jinxiao, SUN Jing, YANG Wenmin, WANG Xiaoyue, WANG Xin, YANG Jian. A preliminary study on characteristics of visual evoked potentials in children with myelin oligodendrocyte glycoprotein immunoglobulin G associated disorders in the acute phase[J].Journal of Clinical Pediatrics, 2022, 40(4): 284-289.

Figures/Tables 3

References 20

[1]	Reindl M, Waters P. Myelin oligodendrocyte glycoprotein antibodies in neurological disease[J]. Nat Rev Neurol, 2019, 15(2):89-102. doi: 10.1038/s41582-018-0112-x
[2]	de Mol CL, Wong Y, van Pelt ED, et al. The clinical spectrum and incidence of anti-MOG-associated acquired demyelinating syndromes in children and adults[J]. Mult Scler, 2020, 26(7):806-814. doi: 10.1177/1352458519845112
[3]	Jarius S, Paul F, Aktas O, et al. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing[J]. J Neuroinflammation, 2018, 15(1):134. doi: 10.1186/s12974-018-1144-2
[4]	中国免疫学会神经免疫分会. 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病诊断和治疗中国专家共识[J]. 中国神经免疫学和神经病学杂志, 2020, 27(2):86-95.
[5]	Fernandez-Carbonell C, Vargas-Lowy D, Musallam A, et al. Clinical and MRI phenotype of children with MOG antibodies[J]. Mult Scler, 2016, 22(2):174-184. doi: 10.1177/1352458515587751
[6]	Waters P, Fadda G, Woodhall M, et al. Serial anti-myelin oligodendrocyte glycoprotein antibody analyses and outcomes in children with demyelinating syndromes[J]. JAMA Neurol, 2020, 77(1):82-93. doi: 10.1001/jamaneurol.2019.2940
[7]	Jurynczyk M, Messina S, Woodhall MR, et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study[J]. Brain, 2017, 140(12):3128-3138. doi: 10.1093/brain/awx276 pmid: 29136091
[8]	Ramanathan S, Mohammad S, Tantsis E, et al. Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination[J]. J Neurol Neurosurg Psychiatry, 2018, 89(2):127-137. doi: 10.1136/jnnp-2017-316880
[9]	Krupp LB, Tardieu M, Amato MP, et al. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions[J]. Mult Scler, 2013, 19(10):1261-1267. doi: 10.1177/1352458513484547
[10]	中华医学会眼科学分会神经眼科学组. 视神经炎诊断和治疗专家共识(2014年)[J]. 中华眼科杂志, 2014, (6):459-463.
[11]	Peschl P, Bradl M, Höftberger R, et al. Myelin oligo-dendrocyte glycoprotein: deciphering a target in inflammatory demyelinating diseases[J]. Front Immunol, 2017, 8:529. doi: 10.3389/fimmu.2017.00529
[12]	Duignan S, Wright S, Rossor T, et al. Myelin oligo-dendrocyte glycoprotein and aquaporin-4 antibodies are highly specific in children with acquired demyelinating syndromes[J]. Dev Med Child Neurol, 2018, 60(9):958-962. doi: 10.1111/dmcn.13703 pmid: 29468668
[13]	潘映辐. 临床诱发电位学 [M]. 2版. 北京: 人民卫生出版社, 2000.
[14]	Jarius S, Ruprecht K, Kleiter I, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome[J]. J Neuroinflammation, 2016, 13(1):280. doi: 10.1186/s12974-016-0718-0
[15]	Salama S, Khan M, Levy M, et al. Radiological cha-racteristics of myelin oligodendrocyte glycoprotein antibody disease[J]. Mult Scler Relat Disord, 2019, 29:15-22. doi: 10.1016/j.msard.2019.01.021
[16]	Ramanathan S, Prelog K, Barnes EH, et al. Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis[J]. Mult Scler, 2016, 22(4):470-482. doi: 10.1177/1352458515593406
[17]	Hennes EM, Baumann M, Schanda K, et al. Prognostic relevance of MOG antibodies in children with an acquired demyelinating syndrome[J]. Neurology, 2017, 89(9):900-908. doi: 10.1212/WNL.0000000000004312
[18]	Tea F, Lopez JA, Ramanathan S, et al. Characterization of the human myelin oligodendrocyte glycoprotein antibody response in demyelination[J]. Acta Neuropathol Commun, 2019, 7(1):145. doi: 10.1186/s40478-019-0786-3
[19]	Jarius S, Ruprecht K, Kleiter I, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 1: frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin[J]. J Neuroinflammation, 2016, 13(1):279. doi: 10.1186/s12974-016-0717-1
[20]	Cobo-Calvo A, Sepúlveda M, D'Indy H, et al. Usefulness of MOG-antibody titres at first episode to predict the future clinical course in adults[J]. J Neurol, 2019, 266(4):806-815. doi: 10.1007/s00415-018-9160-9 pmid: 30607536

组别	眼数	VEP异常	VEP异常表现
组别	眼数	VEP异常	P100波潜伏期延长	P100波潜伏期延长伴波幅下降	P100波波幅下降	P100波缺失
MOG抗体阳性	58	37(63.8)	16(27.6)	7(12.1)	6(10.3)	8(13.8)
MOG抗体阴性	76	37(48.7)	16(21.1)	4(5.3)	13(17.1)	4(5.3)
χ²值		3.04	0.77	1.22	1.24	2.94
P		0.081	0.379	0.269	0.266	0.087

视神经炎组	眼数	VEP异常	VEP异常表现
视神经炎组	眼数	VEP异常	P100波缺失	盲及重度视力损害
MOG抗体阳性	30	23(76.7)	8(26.7)	12(40.0)
MOG抗体阴性	38	28(73.7)	4(10.5)	7(18.4)
χ²值		0.08	2.95	3.99
P		0.778	0.086	0.046

MOG抗体滴度	眼数	VEP异常表现
MOG抗体滴度	眼数	P100波缺失	盲及重度视力损害
1:10	14	2(14.3)	4(28.6)
1:32	10	3(30.0)	6(60.0)
1:100	6	3(50.0)	2(33.3)
P		0.282	0.349

A preliminary study on characteristics of visual evoked potentials in children with myelin oligodendrocyte glycoprotein immunoglobulin G associated disorders in the acute phase

RichHTML

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 3

References 20

Related Articles 15

Metrics

Comments

Recommended 0

[1]	ZOU Liping. Childhood encephalopathy: a group of diseases associated with various diseases [J]. Journal of Clinical Pediatrics, 2023, 41(9): 641-643.
[2]	ZHANG Weihua, ZOU Liping, REN Haitao, GUAN Hongzhi. Beware of the pitfalls in diagnosis and treatment of autoimmune encephalitis in children [J]. Journal of Clinical Pediatrics, 2023, 41(9): 644-649.
[3]	HOU Chi, CHEN Wenxiong, LIAO Yinting, WU Wenxiao, TIAN Yang, ZHU Haixia, PENG Bingwei, ZENG Yiru, WU Wenlin, CHEN Zongzong, LI Xiaojing. Clinical analysis of autoimmune glial fibrillary acidic protein astrocytopathy in children [J]. Journal of Clinical Pediatrics, 2023, 41(9): 656-660.
[4]	YANG Yating, CAI Yuehao, FANG Qiong, CHEN Lang, CHEN Qiaobin, LIN Zhi, WU Feifei, LIN Meng. Clinical analysis of idiopathic and symptomatic occipital lobe epilepsy in children [J]. Journal of Clinical Pediatrics, 2023, 41(9): 668-673.
[5]	HOU Ruolin, WU Jing, LI Ling. Pediatric autoimmune encephalitis with brain MRI showing meningeal thickening and enhancement [J]. Journal of Clinical Pediatrics, 2023, 41(9): 674-679.
[6]	WU Yuefang, SUN Yanling, WU Wanshui, DU Shuxu, LI Miao, SUN Liming. Analysis of prognostic factors and survival status of group 4 medulloblastoma in children [J]. Journal of Clinical Pediatrics, 2023, 41(9): 686-691.
[7]	SUN Juan, LI Haiying, JIA Peisheng, WANG Huaili. Clinical analysis of fulminant myocarditis in 12 children [J]. Journal of Clinical Pediatrics, 2023, 41(9): 692-696.
[8]	Reviewer: WANG Chenhui, Reviser: YANG Hui. Research progress on early screening and diagnosis of Crohn's disease in children [J]. Journal of Clinical Pediatrics, 2023, 41(9): 708-714.
[9]	SHEN Nan, DU Bailu. Strategies for the diagnosis, treatment, and management of invasive fungal infections in children with hematologic neoplasms [J]. Journal of Clinical Pediatrics, 2023, 41(8): 571-577.
[10]	XU Beixue, LIU Quanbo. Clinical analysis of 195 children with invasive pulmonary fungal infection [J]. Journal of Clinical Pediatrics, 2023, 41(8): 584-588.
[11]	CHEN Hongyu, LIU Zihao, WANG Heping, LIAO Cuijuan, LI Li, WANG Wenjian, LAI Jianwei. Role of nontypeable Haemophilus influenzae biofilms in chronic pulmonary infection in children [J]. Journal of Clinical Pediatrics, 2023, 41(8): 589-593.
[12]	KANG Lei, GUO Fang, LI Lifang, BAI Xinfeng, CHENG Caiyun, XU Meixian. Value of metagenomic next-generation sequencing in children with visceral leishmaniasis associated with hemolytic histiocytosis [J]. Journal of Clinical Pediatrics, 2023, 41(8): 594-598.
[13]	SUN Zhicai, LIU Yuling, LI Xiaolin, PAN Xiaofen. Clinical analysis of 15 children with primary nephrotic syndrome complicated with adrenal crisis [J]. Journal of Clinical Pediatrics, 2023, 41(8): 610-612.
[14]	WANG Hongxia, PAN Xiang, LU Jun. Report a case of α-ketoadipic aciduria caused by compound heterozygous variant of DHTKD1 gene [J]. Journal of Clinical Pediatrics, 2023, 41(8): 624-628.
[15]	XI Bixin, HU Qun, LIU Aiguo. Research advances of the bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplant in children [J]. Journal of Clinical Pediatrics, 2023, 41(8): 629-633.