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Myelitis in inflammatory disorders associated with myelin oligodendrocyte glycoprotein antibody and aquaporin‐4 antibody: A comparative study in Chinese Han patients
Author(s) -
ZhangBao Jingzi,
Huang Wenjuan,
Zhou Lei,
Wang Liang,
Chang Xuechun,
Lu Chuanzhen,
Zhao Chongbo,
Lu Jiahong,
Quan Chao
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14654
Subject(s) - medicine , myelitis , neuromyelitis optica , transverse myelitis , myelin oligodendrocyte glycoprotein , multiple sclerosis , pathology , aquaporin 4 , gastroenterology , spinal cord , immunology , experimental autoimmune encephalomyelitis , psychiatry
Background and purpose Myelitis is an important clinical component of myelin oligodendrocyte glycoprotein antibody (MOG‐ab)‐associated disease (MOGAD) and aquaporin‐4 antibody (AQP4‐ab)‐positive neuromyelitis optica spectrum disorder (NMOSD). The aim of this work was to evaluate the differentiating features of myelitis between the two diseases. Methods Myelitis‐related clinical and radiologic data from 130 patients with MOGAD and 125 patients with AQP4‐ab–positive NMOSD were retrospectively reviewed and compared. A scoring model was established to differentiate MOG‐ab–associated myelitis from AQP4‐ab–associated myelitis. Results Overall, 29.2% (38/130) of patients with MOGAD and 66.4% (83/125) of patients with AQP4‐ab–positive NMOSD had ever experienced myelitis. Compared with those with NMOSD, patients with MOGAD exhibited a lower frequency of myelitis, either during the first episode ( p < 0.0001) or throughout the disease duration ( p < 0.0001). Compared with AQP4‐ab–associated myelitis, MOG‐ab–associated myelitis manifested a higher male‐to‐female ratio ( p < 0.0001), younger age at disease onset ( p = 0.0004), more prodromic influenza‐like symptoms ( p = 0.030), more prodromic fever ( p = 0.0003), more bowel and bladder dysfunction ( p = 0.011), less painful tonic spasms ( p < 0.0001), and lower Expanded Disability Status Scale scores after treatment ( p < 0.0001). On magnetic resonance imaging, lower spinal cord lesions ( p = 0.023), short‐segment lesions ( p = 0.021), conus involvement ( p = 0.0001), and H sign ( p < 0.0001) were more common in MOG‐ab–associated myelitis. A scoring model with a cutoff value of 4 differentiated MOG‐ab–associated myelitis from AQP4‐ab–associated myelitis with a sensitivity of 87.9% and a specificity of 90.1%. Conclusions Myelitis was less commonly observed in MOGAD and exhibited distinct features compared to those of AQP4‐ab–positive NMOSD.