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Abstract Details

Prospective characterization of children positive for anti-MOG antibodies meeting Multiple Sclerosis diagnostic criteria
Child Neurology and Developmental Neurology
P4 - Poster Session 4 (5:30 PM-6:30 PM)
7-042
To characterize the clinical features and outcome of children meeting diagnostic criteria for multiple sclerosis (MS) who were seropositive for antibodies against myelin oligodendrocyte glycoprotein (MOGabs).

A minority of subjects meeting the MS diagnostic criteria are MOGabs seropositive (MOG+). Whether these patients exhibit clinical features distinct from typical MS is unclear. 
We assessed the presence of MOGabs in 66 children (median [IQR] age at onset 13.97 [IQR 10.88-15.06] years) diagnosed with MS according to 2010 international diagnostic criteria. Clinical, serological and imaging features were prospectively assessed for a median of 7 years from presentation, and compared between MOG+ and MOG- children using descriptive statistics.

 
At clinical onset, 11/66 (17%) children were MOG+. Seropositive patients were younger (p<0.0001) than seronegative patients, and all presented at age <11 years. The presenting phenotype was optic neuritis (ON) and/or transverse myelitis (TM) for 80% of seropositive versus 41% of the seronegative patients (p =0.019). Brain MRIs at onset were atypical for MS in 9 MOG+ (3 without brain lesions, 3 with diffuse bilateral pattern and 3 with minimal lesions) and 4 MOG- patients (p<0.0001). Oligoclonal bands (OCBs) were detected in 2/8 (25%) MOG+ and in 20/36 (83%) MOG- patients evaluated (p =0.0027). None of the MOG+ patients showed contrast enhancement on baseline MRI, thus none met 2010 McDonald criteria at onset; 2 MOG+ patients met the 2017 criteria due to the presence of OCBs. Of 11 MOG+ patients, 10 developed new brain lesions, 1 developed new spinal cord lesions, and 7 experienced clinical relapses (in almost all cases ON or TM). At last follow-up, total T2 lesion volume in MOG+ patients was significantly smaller compared to MOG- ones (p<0.0001).

While meeting MS diagnostic criteria, children seropositive for MOGabs exhibit clinical and MRI features distinguishing them from MOG-negative typical relapsing MS patients.
Authors/Disclosures
Giulia Fadda, MD (University of Ottawa)
PRESENTER 		Dr. Fadda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon Therapeutics. Dr. Fadda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for roche. Dr. Fadda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fadda has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Novartis.
Patrick Waters, PhD (Oxford Autoimmune Neurology Diagnostic Lab - Nuffield Clinical Neurosciences) Dr. Waters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Waters has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB. Dr. Waters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UBC. The institution of Dr. Waters has received research support from Guthy-Jackson Charitable Foundation. Dr. Waters has received intellectual property interests from a discovery or technology relating to health care.
Nadia M. Celestin, BS (Tisch MS Research Center of New York) Miss Celestin has nothing to disclose.
Sarosh R. Irani, MD, PhD, FRCP, FEAN (Mayo Clinic) Dr. Irani has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for AZ, Roche, Cerebral therapeutics, Biogen, Amgen, Argenex, Clarivate, IQVIA, BioHaven therapeutics.. Dr. Irani has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Brain. Dr. Irani has received intellectual property interests from a discovery or technology relating to health care. Dr. Irani has received intellectual property interests from a discovery or technology relating to health care.
Robert A. Brown, PhD (ShadowLab Reseaerch) Dr. Brown has received stock or an ownership interest from ShadowLab Research Inc.. Dr. Brown has received intellectual property interests from a discovery or technology relating to health care. Dr. Brown has a non-compensated relationship as a consultant with the Population Council that is relevant to AAN interests or activities.
Julia O'Mahony (The Hospital for Sick Children) Ms. O'Mahony has nothing to disclose.
No disclosure on file
Giulia Longoni, MD (The Hospital for Sick Children) Dr. Longoni has nothing to disclose.
E. Ann Yeh, MD, MA, FRCPC (Hospital for Sick Children) Dr. Yeh has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pipeline therapeutics. Dr. Yeh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Yeh has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for SCN. Dr. Yeh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Yeh has received research support from CIHR. The institution of Dr. Yeh has received research support from National MS Society. The institution of Dr. Yeh has received research support from SickKids Foundation. The institution of Dr. Yeh has received research support from MSSC. The institution of Dr. Yeh has received research support from Garry Hurvitz Foundation. The institution of Dr. Yeh has received research support from Leong Centre. The institution of Dr. Yeh has received research support from OMSLife. The institution of Dr. Yeh has received research support from Canada's Drug Agency. Dr. Yeh has received personal compensation in the range of $0-$499 for serving as a Author with Medscape. Dr. Yeh has a non-compensated relationship as a Editorial Board with Neurology that is relevant to AAN interests or activities. Dr. Yeh has a non-compensated relationship as a Editorial Board with MSJ that is relevant to AAN interests or activities.
Ruth-Ann Marrie, MD, PhD (University of Manitoba) The institution of Dr. Marrie has received research support from CIHR. The institution of Dr. Marrie has received research support from MS Canada. The institution of Dr. Marrie has received research support from National MS Society. The institution of Dr. Marrie has received research support from Crohn's and Colitis Canada. The institution of Dr. Marrie has received research support from US Department of Defense. The institution of Dr. Marrie has received research support from The Arthritis Society. The institution of Dr. Marrie has received research support from CMSC.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ) Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Clario.
Brenda L. Banwell, MD, FAAN (Johns Hopkins University) Dr. Banwell has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Banwell has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. Dr. Banwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Banwell has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Banwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Banwell has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Banwell has received research support from National MS Society. The institution of Dr. Banwell has received research support from NIH.
Amit Bar-Or, MD, FRCPC (University of Pennsylvania) Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche Genentech. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merk/EMD Serono. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for cabaletta. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck/EMD Serono. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi/Genzyme. The institution of Dr. Bar-Or has received research support from Novartis. The institution of Dr. Bar-Or has received research support from Biogen. The institution of Dr. Bar-Or has received research support from Roche/Genentech.