Pediatric anti-N-methyl-D-aspartate receptor encephalitis with MOG-Ab co-existence: Relapse propensity and treatability

Abstract

Objectives: To investigate the clinical characteristics of the anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis with anti-myelin oligodendrocyte glycoprotein antibody(MOG-Ab)positivity serostatus in pediatric patients.

Methods: The clinical manifestations, treatments, and outcomes of patients with anti-NMDAR encephalitis with positive MOG-Ab were elaborated. The annualized relapse rates (ARRs) were compared before and during treatment with disease-modifying drugs (DMDs).

Results: Twelve patients were included. In the prospective cohort(Cohort A), MOG-Ab positivity was associated with relapse (p = 0.028, OR = 1.677). Eight cases relapsed, of which six cases were treated with DMDs. The median ARR reduced significantly following DMDs treatments (z = 1.992, P = 0.046).

Conclusions: The anti-NMDAR encephalitis patients with MOG-Ab co-existence are prone to relapse. Long-term DMDs therapy can reduce ARRs.

Keywords: (MOG); Anti-N-methyl-D-aspartate receptor(NMDAR); Disease-modifying drugs(DMDs); Encephalitis; Myelin oligodendrocyte glycoprotein; Relapse.