Clinical Characteristics and Treatment Outcomes of MOGAD: A Detailed Analysis from a Single-Center Four-Year Retrospective Cohort

Yıl 2024, , 164 - 171, 30.06.2024

Alihan Abdullah Akbaş Ömer Elçi Beyzanur Bozkurt Vasfiye Sezer , Abdulkadir Tunç

https://doi.org/10.31832/smj.1438799

Öz

Introduction: This study aims to delineate the prevalence, clinical characteristics, diagnostic findings, and treatment outcomes of Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD) in a cohort over four years, providing a basis for improved diagnostic criteria and therapeutic strategies. Materials and Methods: In a retrospective cohort study at a tertiary care center, we analyzed medical records of 90 patients presenting with CNS demyelinating symptoms, focusing on those diagnosed with MOGAD based on the International MOGAD Panel criteria. Data on clinical presentation, serum Anti-MOG antibody testing, MRI, VEP scans, CSF analysis, and treatment outcomes were evaluated. Results: Among the cohort of 90 patients, 7 patients were identified with positive Anti- MOG antibodies, indicating a prevalence of 7.8%. Clinical manifestations varied widely, including optic neuritis, myelitis, and cerebral cortical encephalitis. Diagnostic findings highlighted the absence of oligoclonal bands in CSF analysis and diverse MRI lesions. Most patients responded well to immunosuppressive treatments, though relapses occurred in two cases. The study underscores the heterogeneity of MOGAD presentations and the importance of personalized treatment approaches. Conclusion: Our findings contribute to the growing understanding of MOGAD, emphasizing its distinct clinical and diagnostic features compared to other CNS demyelinating disorders. The study advocates for the integration of MOG antibody testing in clinical practice to enhance diagnostic accuracy and patient outcomes. Future research should aim at longitudinal and multicentric studies to validate our findings and further refine MOGAD management strategies.

Anahtar Kelimeler

Myelin-Oligodendrocyte Glycoprotein, Demyelinating Diseases, Optic Neuritis, Autoantibodies, Magnetic Resonance Imaging

Miyelin Oligodendrosit Glikoprotein İlişkili Hastalığı (MOGAD): Dört Yıllık Retrospektif Kohort Çalışmasında Prevalans, Klinik Belirtiler ve Tedavi Yanıtları

Öz

Amaç: Bu çalışma, dört yıl boyunca bir kohorttaki Miyelin Oligodendrosit Glikoprotein İlişkili Hastalığın (MOGAD) prevalansını, klinik özelliklerini, tanı bulgularını ve tedavi sonuçlarını açıklamayı ve gelişmiş tanı kriterleri ve tedavi stratejileri için bir temel sağlamayı amaçlamaktadır.
Yöntem ve Gereçler: Üçüncü basamak bir merkezde yapılan retrospektif bir kohort çalışmasında, Uluslararası MOGAD Paneli kriterlerine göre MOGAD tanısı konanlara odaklanarak, Merkezi sinir sistemi (MSS) demiyelinizan semptomlarıyla başvuran 90 hastanın tıbbi kayıtlarını analiz ettik. Klinik tablo, serum Anti-MOG antikor testi, MR, VEP taramaları, BOS analizi ve tedavi sonuçlarına ilişkin veriler değerlendirildi.
Bulgular: 90 hastadan oluşan kohort arasında, 7 hastada pozitif Anti-MOG antikorları belirlendi; bu da %7,8'lik bir prevalansa işaret etmekte idi. Klinik bulgular, optik nörit, miyelit ve serebral kortikal ensefalit dahil olmak üzere çok çeşitli idi. Tanısal bulgular, çeşitli MR lezyonları göstermekle birlikte BOS analizinde oligoklonal bantların bulunmadığını vurguladı. Çoğu hasta immünosupresif tedavilere iyi yanıt verdi, ancak iki vakada rekürrens meydana geldi. Çalışma, MOGAD sunumlarının heterojenliğini ve kişiselleştirilmiş tedavi yaklaşımlarının önemini vurgulamakta idi.
Sonuç: Bulgularımız, MOGAD'ın diğer MSS demiyelinizan hastalıklarla karşılaştırıldığında farklı klinik ve tanısal özelliklerini vurgulayarak, MOGAD'ın giderek daha iyi anlaşılmasına katkıda bulunmaktadır. Çalışma, teşhis doğruluğunu ve hasta sonuçlarını iyileştirmek için MOG antikor testinin klinik uygulamaya entegrasyonunu savunmaktadır. Gelecekteki araştırmalar, bulgularımızı doğrulamak ve MOGAD yönetim stratejilerini daha da geliştirmek için boylamsal ve çok merkezli çalışmaları amaçlamalıdır.

Anahtar Kelimeler

Miyelin-Oligodendrosit Glikoprotein, Demiyelinizan Hastalıklar, Optik Nörit, Otoantikorlar, Manyetik Rezonans Görüntüleme

Etik Beyan

Considering the retrospective design of the study, ethics committee consent was waived However, strict confidentiality andanonymity of patient data were maintained throughout the study, in accordance withethical guidelines and the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.

Destekleyen Kurum

Yok

Kaynakça

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