Pediatric MOGAD: Clinical Experience in a Tertiary Care Setting

ObjectiveTo describe a large single-center cohort of children with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) since the clinical availability of the MOG antibody cell-based assay. BackgroundMOGAD is an inflammatory disease of the central nervous system with various phenotypes, with a predilection towards pediatric patients. Design/MethodsRetrospective chart review was performed on patients that underwent MOG antibody testing from 2018 to present.Clinical and demographic data were collected. Results113 patients with a diagnosis of MOGAD were identified.Median age at presentation was 8.89 years (2-18 years).Fifty-eight patients (53%) were female.Majority of patients identified as white Hispanic (54%), white non-Hispanic (26%), or black (9%) with the remainder being Asian/Pacific Islander.Predominant clinical phenotypes included acute disseminated encephalomyelitis (44%), optic neuritis (36%), encephalitis (12%), and other demyelinating disease (8%).In follow up to date, 39% of patients have experienced clinical relapse; 23 patients having had an isolated relapse, while 10 had numerous clinical relapses.Average time to relapse is 15.8 months, with 70% of relapses occurring within 6 months of initial presentation.Currently, the longest duration from initial presentation to clinical relapse is 6.8 years.An additional 5 patients were found to have positive MOG cell-based assay but ultimately received alternative diagnoses. ConclusionsHere we present a large single-center cohort of pediatric MOGAD.This adds to the current existing literature of pediatric MOGAD and highlights the need for further longitudinal follow-up to better characterize outcomes of MOGAD, including relapse risks which may help further guide decision making in treatment.Additionally, given phenotypic variability, there is need for future multi-center collaboration in the development of registries or natural history studies for large scale data collection.