Anti myelin oligodendrocyte glycoprotein associated immunoglobulin G (AntiMOG-IgG)-associated neuromyelitis optica spectrum disorder with persistent disease activity and residual cognitive impairment

Antibodies targeting myelin oligodendrocyte glycoprotein (MOG) have been recently reported in association with idiopathic inflammatory central nervous system disorders. Initially believed to be a benign disorder, anti MOG-IgG was noted to cause steroid responsive recurrent optic neuritis and isolated longitudinally extensive myelitis. However, there is growing evidence that the disease may be predominantly relapsing, often producing severe visual loss and involving regions other than the spinal cord and optic nerve. We report an adolescent male with an aggressive disease course previously undescribed in anti MOG-IgG-associated disease that left him with residual cognitive dysfunction

Environmental Factors Related to Multiple Sclerosis in Indian Population

<div><p>Background</p><p>Multiple sclerosis (MS) is less prevalent among Indians when compared to white populations. Genetic susceptibility remaining the same it is possible that environmental associations may have a role in determining disease prevalence.</p><p>Aims</p><p>To determine whether childhood infections, vaccination status, past infection with <i>Helicobacter pylori</i> (<i>H</i>.<i>pylori</i>), diet, socioeconomic and educational status were associated with MS.</p><p>Material and Methods</p><p>139 patients and 278 matched control subjects were selected. A validated environmental exposure questionnaire was administered. Estimation of serum <i>H</i>.<i>pylori</i> IgG antibody was done by ELISA. Patients and controls were genotyped for HLA-DRB1*15:01.</p><p>Results</p><p>In our cohort a significant association was seen with measles (<i>p</i> <0.007), vegetarian diet (<i>p</i> < 0.001, higher educational status (<i>p</i> <0.0001) and urban living (<i>p</i> <0.0001). An inverse relationship was seen with <i>H</i>.<i>Pylori</i> infection and MS (<i>p</i> <0.001). Measles infection (OR 6.479, CI 1.21- 34.668, <i>p</i>< 0.029) and high educational status (OR 3.088, CI 1.212- 7.872, <i>p</i>< 0.018) were significant risk factors associated with MS. <i>H</i>.<i>pylori</i> infection was inversely related to MS (OR 0. 319, CI 0.144- 0.706, <i>p</i> <0.005).</p><p>Conclusions</p><p>Environmental influences may be important in determining MS prevalence.</p></div

Demographic and Clinical features

<p>RR = Relapsing Remitting, SP = Secondary progressive, NA = Not applicable</p><p>.</p

Environmental profile in Multiple Sclerosis patients and healthy controls.

<p>Environmental profile in Multiple Sclerosis patients and healthy controls.</p

Supplemental material for MOG-IgG-associated disease has a stereotypical clinical course, asymptomatic visual impairment and good treatment response

<p>Supplemental material for MOG-IgG-associated disease has a stereotypical clinical course, asymptomatic visual impairment and good treatment response by Lekha Pandit, Sharik Mustafa, Ichiro Nakashima, Toshyuki Takahashi and Kimhiko Kaneko in Multiple Sclerosis Journal – Experimental, Translational and Clinical</p

Serological markers associated with neuromyelitis optica spectrum disorders in South India

Background: Neuromyelitis optica spectrum disorders (NMOSDs) represent 20% of all demyelinating disorders in South India. No studies have determined the seroprevalence to both antibodies against aquaporin-4FNx01 and antimyelin oligodendrocyte glycoprotein antibody (anti-MOG+) in this population. Objective: To identify and characterize seropositive patients for anti-aquaporin-4 antibody (anti-AQP4+) and anti-MOG+ in South India. Materials and Methods: We included 125 consecutive patients (15 children) who were serologically characterized using live transfected cells to human M23-AQP4 or full-length MOG. Results: Among a total of 125 patients, 30.4% of patients were anti-AQP4+, 20% were anti-MOG+, and 49.6% were seronegative. No patient was positive for both. Anti-MOG+ patients represented 28.7% (25/87) of seronegative NMOSD. In comparison to anti-AQP4+ patients, anti-MOG+ patients were commonly male, had less frequent attacks and milder disability on expanded disability status score scale. Seronegative patients were also predominantly male, 36% (9/25) had monophasic longitudinally extensive transverse myelitis and disability was comparable with anti-AQP4+ patients. Lumbar cord involvement was common in anti-MOG+ and seronegatives, whereas anti-AQP4+ patients had more cervical lesions. Conclusion: Anti-AQP4+/anti-MOG + patients accounted for nearly half of the patients suspected of having NMOSD in South India, indicating that antibody testing may be useful on the management of subgroups with different prognosis