Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes

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dc.authorscopusid55505087800
dc.authorscopusid7004990930
dc.authorscopusid57223005241
dc.authorscopusid14066373400
dc.authorscopusid16548727600
dc.authorscopusid6603253793
dc.authorscopusid35089072300
dc.contributor.authorYılmaz Ü.
dc.contributor.authorGücüyener K.
dc.contributor.authorYavuz M.
dc.contributor.authorÖncel İ.
dc.contributor.authorCanpolat M.
dc.contributor.authorSaltık S.
dc.contributor.authorÜnver O.
dc.date.accessioned2024-03-09T19:39:57Z
dc.date.available2024-03-09T19:39:57Z
dc.date.issued2022
dc.departmentİzmir Bakırçay Üniversitesien_US
dc.description.abstractBackground: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Türkiye. Clinical and paraclinical features were compared between patients with disease onset before 12 years (earlier onset) and ?12 years (later onset) as well as between our current (2015–2021) and previous (<2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset <12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought. © 2022 European Paediatric Neurology Societyen_US
dc.description.sponsorshipThe authors thank all their colleagues for their help in the follow-up of the patients. Note added in proof: part of the patients in the present cohort were included in the newly published study: Solmaz I, Doran T, Yousefi M, Konuskan B, Oncel I, Vural A, Anlar B. Frequency of myelin oligodendrocyte glycoprotein antibodies in pediatric onset multiple sclerosis. Mult Scler Relat Disord. 2022 Aug 8;68:104097. doi: 10.1016/j.msard.2022.104097. Epub ahead of print. PMID: 35998500.en_US
dc.identifier.doi10.1016/j.ejpn.2022.08.006
dc.identifier.endpage18en_US
dc.identifier.issn1090-3798
dc.identifier.pmid36137476en_US
dc.identifier.scopus2-s2.0-85143379946en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage8en_US
dc.identifier.urihttps://doi.org/10.1016/j.ejpn.2022.08.006
dc.identifier.urihttps://hdl.handle.net/20.500.14034/1581
dc.identifier.volume41en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherW.B. Saunders Ltden_US
dc.relation.ispartofEuropean Journal of Paediatric Neurologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAnti-AQP4-IgG; Anti-MOG-IgG; Antibody; Demyelinating; Pediatric multiple sclerosisen_US
dc.subjectantibody; aquaporin 4 antibody; azathioprine; beta interferon; cladribine; cyclophosphamide; dimethyl fumarate; fingolimod; glatiramer; immunoglobulin; immunoglobulin G antibody; methylprednisolone; myelin oligodendrocyte glycoprotein; natalizumab; ocrelizumab; oligoclonal band; rituximab; teriflunomide; tozinameran; vaxzevria; vitamin D; autoantibody; immunoglobulin G; myelin oligodendrocyte glycoprotein; academic achievement; acute disseminated encephalomyelitis; adolescent; age; Article; brain stem; cerebellum disease; cerebrospinal fluid; child; clinical feature; cohort analysis; comparative study; demographics; differential diagnosis; Expanded Disability Status Scale; female; follow up; groups by age; human; immunofluorescence; incidence; major clinical study; male; multiple sclerosis; neuroimaging; neuropathology; nuclear magnetic resonance imaging; optic neuritis; parental smoking; pediatric patient; prevalence; protein cerebrospinal fluid level; risk factor; seizure; sex; sex ratio; spinal cord lesion; Turkey (republic); virus infection; virus reactivation; vitamin D deficiency; vitamin supplementation; white matter; acute disseminated encephalomyelitis; diagnostic imaging; multiple sclerosis; myelooptic neuropathy; Autoantibodies; Encephalomyelitis, Acute Disseminated; Female; Humans; Immunoglobulin G; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin-Oligodendrocyte Glycoprotein; Neuromyelitis Opticaen_US
dc.titleRe-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromesen_US
dc.typeArticleen_US

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