Clinical And Imaging Characteristics Of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease

Objective:Myelin oligodendrocyte glycoprotein antibody-associated disease(MOGAD)is a newly proposed inflammatory demyelinating disease of the central nervous system in recent years.The purpose of this study is to explore the clinical and imaging features of the disease,and to provide some guidance and suggestions for the effective diagnosis,treatment and improving prognosis of the disease.Methods:Using the method of retrospective analysis,33 cases of MOG antibody-associated diseases diagnosed in Jiangxi Provincial people’s Hospital from June 2020 to October 2022 were collected.Their related data were summarized and analyzed,and the final conclusion was drawn.Results:A total of 33 patients were included in the study.The age of onset was 9-82 years old,with an average age of onset of 38.9±17.7 years.Among them,there were 17 females and 16 males.The ratio of male to female was 1:1.06.There were 9 patients with optic neuritis,accounting for 27.3%,including 5 patients with decreased vision in both eyes.There were 17 patients with myelitis,accounting for 51.5%;and 7 patients with encephalitis,accounting for 21.2%(7/33).MRI manifestations:3 cases showed bilateral optic nerve thickening.17 cases had spinal cord lesions,9 cases of simple long segment,7 cases of simple short segment,1 case of combined long segment and short segment.9 cases cervical cord was involved,thoracic cord was involved in 11 cases,and conus injury was involved in 2 cases.Brain MRI scan found that intracranial lesions were mostly patchy with blurred boundaries,and the deep white matter was most commonly involved.MOG antibody detection showed positive serum antibody in 29 cases,cerebrospinal fluid antibody positive in 11 cases,and 5 patients combined with other immune-related antibody positive.Twenty-eight patients were treated with high-dose corticosteroids in the acute phase,and the symptoms were all significantly relieved.During the six-month follow-up,7 patients relapsed.Conclusion:1.MOG antibody related diseases can occur at all ages,with an average age of 38.9 years old,with a variety of clinical manifestations in females slightly more than males.Myelitis is the most common and it can be a monophasic or recurrent course.2.Imaging findings:optic neuritis is mostly involved in the anterior segment,and myelitis is usually widespread longitudinal transverse myelitis.The thoracic and cervical spinal cord is often involved,and the brain can involve more parts,and the deep white matter is the most common.3.MOG antibodies can be detected in cerebrospinal fluid and are sero-negative.MOG antibodies can coexist with a variety of autoimmune antibodies,among which NMDA antibodies are the most common.4.The cases in this study are all sensitive to hormones,hormone therapy is the best choice.And regular long-term maintenance therapy is the key to reducing the recurrence rate.