LAUSR

This study aimed to determine the seropositivity of myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) and aquaporin-4 antibodies (AQP4-Ab) and outcomes in children with acquired demyelinating syndromes (ADS). Children (6months-15years) with suspected ADS were enrolled and tested for MOG-Ab and AQP4-Ab prospectively over 18 months at a tertiary-care hospital in North India. Children with proven non-immune mediated neurological disorders were enrolled as controls. Of 79 children with suspected ADS, 66 were enrolled. Among the enrolled children with ADS, ADEM (25) was the commonest first clinical event followed by ON (20) and TM [19; one child had ON and TM simultaneously (NMOSD)], while two children had CIS apart from ON and TM. Fourteen (21.2%, CI 11.3-31.1) tested positive for one antibody [12 (18.1%; 95% CI 10.5-25.5%) for MOG-Ab and two (3%; 95% CI 0-7.2%) for AQP4-Ab]. None of the 62 controls tested positive for any antibody. The final diagnosis in those with the monophasic ADS was ADEM (21), ON (13), TM (16), and other CIS (1) while that in children with recurrent events was MDEM (2), NMOSD (3), ADEM-ON (4), recurrent ON (4), and MS (2). Among those with the first event, 4/51 (7.8%; 95%CI 0.5-15.2%) were MOG-Ab positive and two AQP4-Ab positive, whereas, 8/15 [53.3%, (95%CI: 28.1-78.6%)] with recurrent events [MDEM (2), ADEM-ON (4), recurrent ON (1), and recurrent TM (1)] were MOG-Ab positive. Hence, MOG-Ab are the most common antibodies detected in one in five children with pediatric ADS, especially in relapsing disease. AQP4-Ab are rare in children with ADS.