Abstract Details

Title Risk Factors for Transverse Myelitis Compared with Multiple Sclerosis, Neuromyelitis Optica, and Other Neurologic Disorders in Pediatric Patients

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 121

Objective

Background BACKGROUND: TM has substantial clinical overlap, especially on initial presentation, with other autoimmune disorders, including MS and neuromyelitis optica (NMO). Risk factors for TM are not known.

Design/Methods DESIGN/METHODS: Sera were collected from pediatric TM patients and neurologic controls, and from pediatric MS and NMO patients early in disease course through Stony Brook Pediatric MS Centers and the Accelerated Cure/Guthy Jackson Biobank. Serum 25-hydroxy-vitamin D levels were measured by chemoluminescent immunoassay. Antibodies against EBV (EBNA-1), HSV, and CMV were measured by ELISA. HLA-DRB1 allele status was measured by PCR. Logistic regression models, adjusting for age at draw, were used to compare risk factors between TM and the other groups.

Results RESULTS: Blood samples were collected for patients with TM (n=16), NMO (n=34), MS (n=184), and neurologic controls (n=31). Median ages at disease onset were 12.3 years (0.4-17.0 years), 11.0 years (1.9-17.3 years), and 14.3 years (1.4-19.2 years) for TM, NMO, and MS, respectively. TM patients were less likely to have been exposed to EBV as compared to MS patients (OR 0.021, p<0.001) and NMO patients (OR 0.154, p=0.054), but had similar frequency as controls (OR 0.62, p=0.573). Vitamin D data are still in progress. No difference was seen in the frequency of DRB1*1501 allele or exposure to CMV in TM patients as compared to neurologic controls, NMO patients, and MS patients.

Conclusions CONCLUSIONS: Unlike pediatric and adult MS, EBV exposure does not appear to be associated with TM in pediatric patients. Larger studies are needed to confirm this association.

Authors/Disclosures
PRESENTER	No disclosure on file
Jennifer Graves, MD, PhD (UCSD)	Dr. Graves has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Graves has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Graves has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MSJ. The institution of Dr. Graves has received research support from Octave. The institution of Dr. Graves has received research support from Sanofi. The institution of Dr. Graves has received research support from EMD Serono.
Ellen M. Mowry, MD, FAAN (Johns Hopkins University)	Dr. Mowry 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. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SetPoint. The institution of Dr. Mowry has received research support from Genentech/Roche. The institution of Dr. Mowry has received research support from Biogen. Dr. Mowry has received publishing royalties from a publication relating to health care.
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.
Anita L. Belman, MD, FAAN	No disclosure on file
Kurt Marhardt (Merck Ges.m.bH.)	No disclosure on file
	No disclosure on file
	No disclosure on file
Emmanuelle Waubant, MD, PhD, FAAN (USCF MS Center)	The institution of Dr. Waubant has received research support from NIH. The institution of Dr. Waubant has received research support from NMSS. The institution of Dr. Waubant has received research support from PCORI. The institution of Dr. Waubant has received research support from Race to Erase MS. The institution of Dr. Waubant has received research support from Roche. The institution of Dr. Waubant has received research support from Department of Defense. Dr. Waubant has received publishing royalties from a publication relating to health care.

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