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Multiple Sclerosis Is Rare in Epstein–Barr Virus–Seronegative Children with Central Nervous System Inflammatory Demyelination
Author(s) -
Nourbakhsh Bardia,
Cordano Christian,
Asteggiano Carlo,
Ruprecht Klemens,
Otto Carolin,
Rutatangwa Alice,
Lui Allysa,
Hart Janace,
Flanagan Eoin P.,
James Judith A.,
Waubant Emmanuelle
Publication year - 2021
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.26062
Subject(s) - multiple sclerosis , myelin oligodendrocyte glycoprotein , medicine , immunology , epstein–barr virus , antibody , disease , clinically isolated syndrome , oligodendrocyte , virus , demyelinating disease , central nervous system , myelin , pathology , experimental autoimmune encephalomyelitis
Although Epstein–Barr virus (EBV) is hypothesized to be a prerequisite for multiple sclerosis (MS), up to 15% of children with a diagnosis of MS were reported to be EBV‐seronegative. When re‐evaluating 25 EBV‐seronegative children out of 189 pediatric patients with a diagnosis of clinically isolated syndrome/MS, we found anti–myelin oligodendrocyte glycoprotein (MOG) antibody in 11 of 25 (44%) EBV‐seronegative but only 9 of 164 (5.5%, p  < 0.001) EBV‐seropositive patients. After critical review, MS remained a plausible diagnosis in only 4 of 14 EBV‐seronegative/MOG antibody–negative patients. In children with an MS‐like presentation, EBV seronegativity should alert clinicians to consider diagnoses other than MS, especially MOG‐antibody disease. ANN NEUROL 2021;89:1234–1239

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