Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein

Sümeyye Koç¹, Sedat Şen², Yüksel Terzi³, Ferah Kızılay⁴, Serkan Demir⁵, Dürdane Bekar Aksoy⁶, Fatma Kurtuluş⁷, Nuray Bilge⁸, Egemen Idilman⁹, Cihat Uzunköprü¹⁰, Serdal Güngör¹¹, Vedat Çilingir¹², Özlem Ethemoğlu¹³, Cavit Boz¹⁴, Haluk Gümüş¹⁵, Ahmet Kasım Kılıç¹⁶, Ayşin Kısabay¹⁷, Levent Sinan Bir¹⁸, Ömer Faruk Turan¹⁹, Aysun Soysal²⁰, Mesrure Köseoğlu²⁰, Gülnur Tekgöl Uzuner²¹, Hasan Bayındır¹³, Sibel Canbaz Kabay²², Mustafa Çam²³, Vildan Yayla²⁴, Hüseyin Tan⁸, Abdülcemal Özcan¹¹, Özlem Taşkapıoğlu²⁵, Muammer Korkmaz²⁶, Yusuf Tamam²⁷, Yılmaz İnanç²⁸, Hüsnü Efendi²⁹, Dilcan Kotan³⁰, Mehmet Fatih Yetkin³¹, Adnan Burak Bilgiç³², Hikmet Saçmacı³³, Serpil Demirci³⁴, Yahya Çelik³⁵, Turan Poyraz³⁶, Murat Terzi²

¹Department of Neuroscience, Ondokuz Mayıs University Institute of Graduate Studies, Samsun, Türkiye
²Department of Neurology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
³Department of Statistics, Ondokuz Mayıs University Faculty of Science and Literature, Samsun, Türkiye
⁴Department of Neurology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
⁵Clinic of Neurology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye
⁶Department of Neurology, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Türkiye
⁷Clinic of Neurology, Antalya Training and Research Hospital, Antalya, Türkiye
⁸Department of Neurology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
⁹Department of Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye
¹⁰Department of Neurology, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Türkiye
¹¹Department of Pediatric Neurology, İnönü University Faculty of Medicine, Malatya, Türkiye
¹²Department of Neurology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye
¹³Department of Neurology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
¹⁴Department of Neurology, Karadeniz Teknik University Faculty of Medicine, Trabzon, Türkiye
¹⁵Clinic of Neurology, Selçuk University Faculty of Medicine, Konya, Türkiye
¹⁶Department of Neurology, University of Health Sciences Türkiye, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
¹⁷Department of Neurology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Türkiye
¹⁸Department of Neurology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
¹⁹Department of Neurology, Bursa Uludağ University Faculty of Medicine, Bursa, Türkiye
²⁰Clinic of Neurology, University of Health Sciences Türkiye, Bakırköy Prof. Dr. Mashar Osman Training and Research Hospital, İstanbul, Türkiye
²¹Department of Neurology, Eskişehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
²²Clinic of Neurology, Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Türkiye
²³Department of Neurology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
²⁴Clinic of Neurology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
²⁵Department of Neurology, Acıbadem University Faculty of Medicine, İstanbul, Türkiye
²⁶Department of Neurology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Türkiye
²⁷Department of Neurology, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
²⁸Department of Neurology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Türkiye
²⁹Department of Neurology, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
³⁰Clinic of Neurology, Sakarya Training and Research Hospital, Sakarya, Türkiye
³¹Department of Neurology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
³²Clinic of Neurology, Samsun Training and Research Hospital, Samsun, Türkiye
³³Department of Neurology, Bozok University Faculty of Medicine, Yozgat, Türkiye
³⁴Department of Neurology, Süleyman Demirel University Faculty of Medicine, Isparta, Türkiye
³⁵Clinic of Neurology, Private Ada Tıp Hospital, Sakarya, Türkiye
³⁶Clinic of Neurology, Private Medifema Hospital, İzmir, Türkiye

DOI : 10.4274/balkanmedj.galenos.2024.2024-1-97

Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited.
Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG.
Study Design: Multicenter, retrospective, observational study.
Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University’s Faculty of Medicine were included in the study.
Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients.
Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.