Document Type : Original Article
- Masoud Etemadifar 1
- Ahmad Chitsaz 1
- Sahebeh Rajabkhah 2
- Hossein Tavakoli 3
- Arezoo Shafieyoun 4
- Pegah Noorshargh 5
- Mahdieh Afzali 1
1 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada
4 Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
5 Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
Background: The aim of this study was to evaluate the status of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in patients with transverse
myelitis (TM) and compare the clinical and imaging characteristics of MOG immunoglobulin G (IgG)-positive with negative cases.
Methods: This cohort study enrolled 71 patients diagnosed with new-onset of TM who were being followed at a referral university clinic in Isfahan, Iran, from November 2016 to January 2019. Magnetic resonance imaging (MRI) images and blood samples for anti-MOG, anti-aquaporin 4 (anti-AQP4) (using the cell-based technique), and vasculitis-related antibodies were collected from patients. Outcomes were assessed by the evolution of the Expanded Disability Status Scale (EDSS) score and brain and spinal cord imaging findings
within three months. All patients underwent imaging and clinical assessment during a mean period of one year as a follow-up. We compared the characteristics of clinical and radiological outcomes in MOG-IgG-positive and negative cases.
Results: Of the total population studied, there were 26.8% men and 73.2% women, with a mean age of
33 ± 10 years. 12 (16.9%) patients were seropositive for MOG antibody and 17 (89.5%) were positive for
anti-AQP4 antibodies. There was no significant association between anti-MOG antibody seropositivity and age, gender distribution, the presence of other autoimmune diseases, and number and interval of relapses. However, the involvement site of the spine at first imaging was significantly different between seronegative and seropositive patients.
Conclusion: In patients with MOG antibody disease (MOG-AD) TM, the MRI findings suggest a preferential involvement of the cervical-thoracic section in seropositive cases which may help differentiate from non-MOG demyelination TM.
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