Abstract Details

Title Shapeshifter: The Diverse Clinical and Radiologic Phenotypes Associated with MOG Antibody-Associated Disease

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 111

Objective To define the clinical, radiologic, and laboratory features of MOG antibody-associated disease (MOGAD).

Background MOGAD is an autoimmune demyelinating disease of the central nervous system, defined by autoantibodies to myelin oligodendrocyte glycoprotein (MOG). MOGAD classically presents with recurrent optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM) in adults. However, the full spectrum of the recently described disease is unknown.

Design/Methods Records of all patients treated in our neuroimmunology clinic, which serves the Greater Cincinnati and Northern Kentucky regions, were searched using the Epic SlicerDicer tool. All records with positive testing for IgG antibodies against MOG, as measured by fluorescence-activated cell sorting (FACS), were included in this retrospective chart review. No records were excluded on the basis of clinical or radiologic features. Following abstraction, case descriptors were verified by two independent neurologists.

Results MOG reactivity was observed in 22 patients. Patients were predominantly female (59.1%) and white (90.9%). The median age of onset was 37 years (range 5-58). ON occurred in eleven cases (50.0%); this was typically recurrent (72.7%) and occasionally bilateral at onset (18.2%). Nearly half had evidence of optic nerve atrophy on subsequent imaging (45.5%). Transverse myelitis affected 72.7% of patients, but LETM was only observed in one case. Brainstem syndromes, including area postrema syndrome and diplopia, were seen in 40.9% of patients. A subset of patients had features more typical of multiple sclerosis, including periventricular ovoid lesions (54.5%), juxtacortical lesions (22.7%), and oligoclonal bands in cerebrospinal fluid (27.3%).

Conclusions The clinical presentation of MOGAD may be more variable than what has been previously understood. Patients diagnosed with other autoimmune neurological conditions, such as seronegative neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS), may benefit from testing for MOG IgG.

Authors/Disclosures
Samuel B. Marcucci, MD (UC Health Department of Neurology and Rehabilitation Medicine) PRESENTER	The institution of Mr. Marcucci has received research support from Foundation of the Consortium of Multiple Sclerosis Centers.
Rosemarie E. Walch, DO (Memorial Institute for Neuroscience)	Dr. Walch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Walch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb . Dr. Walch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Walch has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Horizon. Dr. Walch has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Walch has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Walch has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Walch has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Horizon. Dr. Walch has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Walch has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Walch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. The institution of Dr. Walch has received research support from Genentech/Roche. The institution of Dr. Walch has received research support from Sanofi. The institution of Dr. Walch has received research support from EMD Serono. Dr. Walch has received research support from TG Therapeutics . The institution of Dr. Walch has received research support from Novartis. The institution of Dr. Walch has received research support from Alexion. The institution of Dr. Walch has received research support from Amgen .
Ameneh Zare Shahabadi, MD, MPH	Dr. Zare Shahabadi has nothing to disclose.
	No disclosure on file
Roman M. Kassa, MD (Norton Medical Group)	Dr. Kassa has nothing to disclose.
Lawrence P. Goldstick, MD (University of Cincinnati UC Physcians Department of Neurology)	Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for biogen. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for genentech. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for sanofi Aventis genzyme. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for emd serono. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TGA therapeutics. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for emd serono. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Aventis genzyme. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for genentech. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Meyers Squibb. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TGA therapeutics. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for biogen. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for bristol meyers squibb. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for genentech. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for sanofi aventis genzyme. Dr. Goldstick has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for emd serono. Dr. Goldstick has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for TGA therapeutics. The institution of Dr. Goldstick has received research support from biogen. The institution of Dr. Goldstick has received research support from lily. The institution of Dr. Goldstick has received research support from sanofi Aventis genzyme. The institution of Dr. Goldstick has received research support from genetech.
	No disclosure on file
Aram Zabeti, MD (University of Cincinnati/Dept of Neurology)	Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Zabeti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Octave. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Zabeti has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Biogen. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD-Serono. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi-Genzyme. Dr. Zabeti has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Horizon. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Janssen . Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for BMS. Dr. Zabeti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for TG.

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