Anti-myelin oligodendrocyte glycoprotein antibody associated disease spectrum – A north Indian tertiary care center experience and review of literature

Abstract Introduction MOG antibody associated disease is a relatively new disorder for which the full clinical spectrum is being described and the literature is evolving. The current study outlines the observations on a cohort of patients diagnosed with this clinical entity. Methods This is a retrospective review of prospectively followed up patients with MOG antibody positive neurological illness. Case records of patients following up in neuroimmunology clinic of All India Institute of Medical Sciences(AIIMS), New Delhi from January 2007 to July 2019 were reviewed for MOG antibody positivity and those patients with positive antibody result were included in this study. Findings A total of 20 patients tested positive for MOG-IgG antibody. 75% were females. Median (Range) age was 30.5 years(8–58). Median disease duration was 22 months(1–139). Most common symptom at presentation was decrease in vision(unilateral or bilateral)(80%). Most common syndrome at onset was unilateral optic neuritis(ON)(40%) followed by bilateral ON(35%), transverse myelitis(TM)(15%), ON plus TM(5%) and cerebral syndrome(5%). Median number of demyelinating episodes per person was 2.5(Delarasse et al., 2006; Peschl et al., 2017; Berger et al., 2003; Kuhle et al., 2007; O'Connor et al., 2007; Jarius et al., 2018). Out of 29 affected eyes, 23 had good outcome. Out of 7 patients with motor disability, 4 patients had good outcome. Conclusion MOG antibody associated disease presents predominantly as recurrent ON, but may also present as an opticospinal, cerebral or brainstem syndrome and recurrent myelitis. Many of the patients had relapses, but had good outcomes with treatment.