Clinical Features Of MOGAD And Factors Related To Recurrence

Objective:MOG-IgG-associated disease(MOGAD)is a newly named demyelinating disease of the central nervous system targeting the glycoprotein of myelin oliogendrocytic cells,which may occur repeatedly in a short period of time and lead to residual disability.MOGAD is rare but with varied clinical manifestations,and it is difficult to diagnose as it is similar to other demyelinating diseases.Repeated relapses may lead to adverse consequences,but the risk factors is not clear.We made a single-center study.Here,we summarized the clinical characteristics of MOGAD patients in our department and analyzed the association between these clinical characteristics and the risk of recurrence.Methods:Patients diagnosed with MOGAD in the Department of Neurology of our hospital from March 2018 to November 2020 were retrospectively analyzed.This study summarized the epidemiological characteristics,clinical symptoms,laboratory tests,radiographic features,and clinical outcomes of these patients.According to the course of the disease,the patients were divided into uniphasic course and recurrent course,and were compared between the two groups.Results:Among the 24 Patients,17 cases(70.8%)were in the uniphasic course group,and 7cases(29.2%)were in the relapsing course group.Overall,there were a bit more females(58.3%),and no statistically significant difference between the two groups.33.3% of the patients had history of prodrome infection before the first onset,besides,prodrome events such as fatigue(8.3%)and trauma(4.2%)also been observed.The serum MOG-IgG titer of73.9% patients was lower(≤ 1:32),and the serum antibody titer of patients in the relapsing course group was higher(57.1%/12.5%,P=0.045)than that of the uniphasic course group.The incidence phenotypes included encephalitis(50%),myelitis(45.8%),and optic neuritis(45.8%).66.7% of the patients had a single phenotype,and 33.3% of the patients had two or more phenotypes.Optic neuritis was more common in the recurrent course group(85.7%/29.4%,P=0.023),and there was no significant difference in the occurance of myelitis and encephalitis between the two groups.33.3% of the patients had a previous history or background of immunity,and the proportion was higher in recurrent course group than that in anothor group 71.4%/17.6%,P=0.021).In the adjuvant examination,the recurrent course group was more likely to have higher CSF white blood cell count(60%/0,P=0.045),but the number of MRI focus and location of them had no significance.45.8%of patients with severe disease(MRS score ≥2)were admitted to hospital,and there was distinctly more severe patients in the relapse course group(85.7%/29.4%,P=0.023).69.6%of the patients performed well after the first attack(MRS score < 2),with no significant difference between the two groups and association with methods of therapy.Conclusion:Our study suggests that MOGAD is a disease with vision loss,limb/face numbness,eye/socket pain as the most common systems.Despite these limitations,the current findings suggest that some clinical characteristics of patients,such as the onset phenotype of optic neuritis,severe condition on admission,history of immune diseases,high antibody titers,and higher count of white cell in cerebrospinal fluid,may be predictive of recurrence.