Abstract Details

Title Peripheral Nervous System Manifestations of MOG Antibody Associated Disease

Topic Autoimmune Neurology

Presentation(s) P9 - Poster Session 9 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-015

Objective

To determine the pattern of peripheral nervous system involvement in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Background

Recent studies have reported peripheral neuropathies in patients harboring myelin oligodendrocyte glycoprotein (MOG) antibodies but often lacked testing of disease controls.

Design/Methods

It was a retrospective cohort study carried out at Mayo Clinic (Minnesota, Florida, and Arizona). Patients consecutively tested for MOG-IgG1 (January 1, 2003, to June 30, 2021) were included. Healthy human controls’ spinal cord, root and dorsal root ganglion were examined for MOG expression. All MOG-IgG1 seropositive patients were divided into three groups a) MOGAD with PNS involvement b) MOGAD with an alternate etiology of PNS involvement c) MOG-IgG1 false positive cases with PNS involvement. Archived sera from well characterized neuropathy/neuronopathy patients (n=196) were also evaluated for MOG-IgG1.

Results

From a total of 279 patients , 215 fulfilled the international MOGAD diagnostic criteria. 15 of them were found to have PNS involvement. Six (median titer 1:40 (range 1:20 -1:100)) out of 215 MOGAD patients had PNS involvement that occurred concurrently with CNS demyelinating episode. Polyradiculopathy (6/6) was the most common phenotype of PNS disease. MRI of all six patients showed enhancement of the cauda equina nerve roots. Nine (median titer 1:500 (range 1:20-1:1000)) patients with true positive MOG-IgG1 had PNS involvement that was temporally unrelated to a CNS demyelinating event. All these patients had an alternate etiology of PNS involvement. Additionally, five (median titer 1:20 ) out of 196 patients sera from well characterized neuropathy/neuronopathy with an alternative etiology tested positive for MOG-IgG1 (amyotrophic lateral sclerosis, n =3; small fiber neuropathy, n =1; distal acquired demyelinating sensory neuropathy, n =1).

Conclusions Peripheral neuropathy is not a feature of MOGAD but inflammatory nerve root involvement can occur concurrently with CNS demyelinating events.

Authors/Disclosures
Pranjal Gupta, MD PRESENTER	Dr. Gupta has nothing to disclose.
Pritikanta Paul, MD (University of California, San Francisco)	The institution of Dr. Paul has received research support from ZS Associates.
Vyanka Redenbaugh, MB BCh BAO (Mayo Clinic)	Dr. Redenbaugh has nothing to disclose.
Yong Guo	Yong Guo has nothing to disclose.
Claudia F. Lucchinetti, MD, FAAN (University of De Medical School, Health Learning Blg)	The institution of Dr. Lucchinetti has received research support from Biogen Idec. The institution of Dr. Lucchinetti has received research support from NIH/NINDS. The institution of Dr. Lucchinetti has received research support from National Institute of Neurological Disorders and Stroke . The institution of Dr. Lucchinetti has received research support from National Multiple Sclerosis Society. The institution of Dr. Lucchinetti has received research support from National Center for Advancing Translational Sciences. Dr. Lucchinetti has received intellectual property interests from a discovery or technology relating to health care. Dr. Lucchinetti has a non-compensated relationship as a Member with National Institute of Neurological Disorders that is relevant to AAN interests or activities. Dr. Lucchinetti has a non-compensated relationship as a Member with Board of Directors, Association of University Professors of Neurology that is relevant to AAN interests or activities. Dr. Lucchinetti has a non-compensated relationship as a Member with Mayo Clinic Board of Trustees that is relevant to AAN interests or activities. Dr. Lucchinetti has a non-compensated relationship as a Member with Mayo Clinic Board of Governors that is relevant to AAN interests or activities.
Yahya J. Abdulrahman	Mr. Abdulrahman has nothing to disclose.
Abhigyan Datta, MD (University of Minnesota)	Dr. Datta has nothing to disclose.
Shailee S. Shah, MD	Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Shah has received publishing royalties from a publication relating to health care.
Christopher J. Klein, MD, FAAN (Mayo Clinic)	Dr. Klein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD Pharma.
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology)	Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Pittock 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. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
Eoin P. Flanagan, MBBCh, FAAN (Mayo Clinic)	The institution of Dr. Flanagan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pharmacy times. The institution of Dr. Flanagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Roche. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Merck. The institution of Dr. Flanagan has received research support from Roche. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has a non-compensated relationship as a Member of medical Advisory Board with The MOG Project that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Journal of The Neurologic Sciences that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Neuroimmunology Reports that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology, Neuroimmunology Neuroinflammation (N2) Journal that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology that is relevant to AAN interests or activities.
Divyanshu Dubey, MD, FAAN (Mayo Clinic)	The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from UCB. Dr. Dubey has received research support from David J. Tomassoni ALS Research Grant Program . Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care.

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