Pediatric MOG-Ab–Associated Encephalitis
Nee Na Kim, Dimitrios Champsas, Michael Eyre, Omar Abdel‐Mannan, Vanessa Wan Mun Lee, Alison Skippen, Manali V. Chitre, Rob Forsyth, Cheryl Hemingway, Rachel Kneen, Ming Lim, Dipak Ram, Sithara Ramdas, Evangeline Wassmer, Siobhan West, Sukhvir Wright, Asthik Biswas, Kshitij Mankad, Eoin P. Flanagan, Jacqueline Palace, Thomas Rossor, Olga Ciccarelli, Yael Hacohen
Abstract
BACKGROUND AND OBJECTIVES: Antibodies to myelin oligodendrocyte glycoprotein (MOG-Ab) have recently been reported in patients with encephalitis who do not fulfill criteria for acute disseminated encephalomyelitis (ADEM). We evaluated a cohort of these children and compared them with children with ADEM. METHODS: Fisher exact test for statistical analysis. RESULTS: = 0.003). DISCUSSION: MOG-Ab should be tested in all patients with suspected encephalitis even in the context of initially normal brain MRI. Although exclusion of infections should be part of the diagnostic process of any child with encephalitis, in immunocompetent children, when herpes simplex virus CSF PCR and gram stains are negative, these features do not preclude the diagnosis of immune mediated disease and should not delay initiation of first-line immunosuppression (steroids, IVIG, plasma exchange), even while awaiting the antibody results.