Anti-MOG antibody associated long segment myelitis presenting as anterior cord syndrome

2021 ◽  
Vol 14 (5) ◽  
pp. e240055
Author(s):  
Amlan Kusum Datta ◽  
Adreesh Mukherjee ◽  
Biman Kanti Ray ◽  
Atanu Biswas
Keyword(s):  
Mycophenolate Mofetil ◽  
Clinical Features ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Immunosuppressant Therapy ◽  
Pulse Methylprednisolone ◽  
Clinical Recovery ◽  
Antibody Positivity

A patient having clinical features reminiscent of anterior cord syndrome (ACS) was found to have long segment myelitis on MRI. Investigations revealed serum anti-myelin oligodendrocyte glycoprotein (MOG) antibody positivity. He was treated with pulse methylprednisolone followed by immunosuppressant therapy with mycophenolate mofetil, which led to clinical recovery. Anterior cord syndrome has so far not been reported in the context of anti-MOG antibody associated disease.

scholarly journals Differences in Clinical Features of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Optic Neuritis in White and Asian Race

2020 ◽  
Vol 219 ◽  
pp. 332-340 ◽  
Author(s):  
Tanyatuth Padungkiatsagul ◽  
John J. Chen ◽  
Panitha Jindahra ◽  
Tetsuya Akaishi ◽  
Toshiyuki Takahashi ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Clinical Features ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Asian Race

scholarly journals Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders

2020 ◽  
Vol 7 (3) ◽  
pp. e705 ◽  
Author(s):  
Shengde Li ◽  
Haitao Ren ◽  
Yan Xu ◽  
Tao Xu ◽  
Yao Zhang ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Proportional Hazards ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
College Hospital ◽  
Relapse Risk ◽  
Medical College ◽  
Cox Proportional Hazards Models

ObjectiveTo investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs).MethodsThis prospective observational cohort study included patients with MOGAD at Peking Union Medical College Hospital between January 1, 2017, and April 30, 2019. The patients were divided into 2 groups: those with (MMF+) or without (MMF−) MMF therapy. The primary outcome was relapse at follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) for relapse.ResultsSeventy-nine patients were included in our MOG cohort. Fifty (63.3%) were adults at index date, and 47 (59.5%) were women. Fifty-four (68.4%) were in the MMF+ group, and 25 (31.6%) were in the MMF− group. Clinical and demographic factors, MOG-IgG titer, and follow-up time (median, 472.5 days for MMF+, 261.0 days for MMF−) were comparable between the groups. Relapse rates were 7.4% (4/54) in the MMF+ group and 44.0% (11/25) in the MMF− group. Of all potential confounders, only the use of MMF was associated with reduced risk of relapse. The HR for relapse among patients in the MMF+ group was 0.14 (95% CI, 0.05–0.45) and was 0.08 (95% CI, 0.02–0.28) in a model adjusted for age, sex, disease course, and MOG-IgG titer. MMF therapy also remained associated with a reduced relapse risk in sensitivity analyses. Only one patient (1.9%) discontinued MMF therapy because of adverse effect.ConclusionsThese findings provide a clinical evidence that MMF immunosuppression therapy may prevent relapse in patients with MOGAD.Classification of evidenceThis study provides class IV evidence that for patients with MOGAD, MMF reduces relapse risk.

scholarly journals An overview of idiopathic optic neuritis in eastern Nepal

1970 ◽  
Vol 2 (1) ◽  
pp. 10-15
Author(s):  
H Das ◽  
Maria Gautam ◽  
P Lavaju
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Steroid Therapy ◽  
Pulse Methylprednisolone ◽  
Pulse Steroid Therapy ◽  
Initial Visual Acuity ◽  
Pulse Methylprednisolone Therapy ◽  
Pulse Steroid

Background: Inflammation of the optic nerve is a common cause of visual loss due to optic nerve pathology. Objective: To report the clinical features, demographic pattern and response to pulse steroid therapy in patients with idiopathic optic neuritis in eastern Nepal. Materials and methods: The hospital data of patients with idiopathic optic neuritis admitted to the department of ophthalmology in a tertiary level center in eastern Nepal between Jan 2000 to Dec 2006 were retrospectively analyzed. The parameters studied were demographic pattern, clinical features, visual acuity and field defects. Results: Thirty-six patients (52 eyes) were found to have optic neuritis (papillits in 36 and retrobulbar optic neuritis in16 eyes). The male to female ratio was1.25:1. The mean age of the patients was 33.56±17.88 years (95 % CI=24.66 - 42.45). The most common modes of presentation were loss of visual acuity and color vision defect. One patient had features suggestive of multiple sclerosis. Vision improved in 42 eyes at discharge from the hospital. Response to pulse methylprednisolone therapy was good in most (42 eyes) of the cases except for the patients having initial visual acuity of no light perception. Conclusion: Response to pulse methylprednisolone therapy is good in patients with initial visual acuity of at least perception of light. Demographic and clinical features of our patients were different from those reported from the western world. Some similarity was observed between studies reported from the oriental countries. Keywords: optic neuritis; demographic pattern; pulse steroid therapy. DOI: 10.3126/nepjoph.v2i1.3698 Nep J Oph 2010;2(1):10-15

scholarly journals Clinical Characteristics and Outcome of Primary Sjogren’s Syndrome: A Large Asian Indian Cohort

2015 ◽  
Vol 9 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Pulukool Sandhya ◽  
Lakshmanan Jeyaseelan ◽  
Robert Hal Scofield ◽  
Debashish Danda
Keyword(s):  
Cluster Analysis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Features ◽  
Asian Indian ◽  
High Antibody ◽  
Multivariate Logistic Regression ◽  
Mild Disease ◽  
Antibody Positivity ◽  
Antibody Titers

Objective : To characterise the clinical features, immunological profile and outcome in a cohort of Asian Indian patients with primary Sjögren's syndrome (SS). Methods : Electronic medical records from a tertiary care teaching hospital in south India were screened for SS between 2004 and 2011. Patients fulfilling American European Consensus group (AECG) 2002 or American College of Rheumatology (ACR) 2012 classification criteria were included. Agglomerative hierarchical cluster analysis to identify patterns of associations between clinical and immunological features was done. Multivariate logistic regression to identify predictors of major systemic involvement was performed. Data on treatment and outcome were retrieved from electronic records. Results : Of 423 patients suspected to have SS, 332 fulfilled inclusion criteria. Only 8.3% of patients complained of sicca symptoms on their own at initial presentation. Younger age of onset, higher female to male ratio, paucity of cryoglobulinemia, Raynaud’s phenomenon and hyperglobulinemia were unique to this cohort. Cluster analysis revealed two subsets: The first cluster comprised of patients having a major systemic illness with high antibody titers and the second comprised of seronegative patients with mild disease. Over a third of SS cases had severe systemic manifestations necessitating treatment with immunosuppressants. In multivariate logistic regression analysis, anti-Ro and anti-La antibody positivity was associated with higher odds for systemic disease features (OR=2.67, P=0.03 and OR=3.25, P=0.003, respectively) whereas chronic pain was associated with lower odds (OR=0.4, p=0.032). Clinical improvement including symptomatic benefit in sicca and musculoskeletal features was noted with immunomodulators in the majority. Conclusion : Our cohort of patients with SS has characteristic clinical features; some of them are in contrast with previous observations reported in European patients. This cohort consisted of two distinct patient clusters. The first cluster was associated with major systemic illness and high antibody titers, where as the second cluster comprised of seronegative patients with mild disease. Association of antibody positivity with systemic features was further confirmed on logistic regression analysis.

scholarly journals 197 Clinical features and prevalence of double antibody positivity in a large cohort of systemic sclerosis patients

Rheumatology ◽  
2018 ◽  
Vol 57 (suppl_3) ◽  
Author(s):  
Alper Sari ◽  
Corrado Campochiaro ◽  
Svetlana Nihtyanova ◽  
Jenny Harvey ◽  
Carmen Fonseca ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Clinical Features ◽  
Large Cohort ◽  
Double Antibody ◽  
Antibody Positivity

Combination immunosuppressant therapy for patients with chronic refractory immune thrombocytopenic purpura

Blood ◽  
2010 ◽  
Vol 115 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Donald M. Arnold ◽  
Ishac Nazi ◽  
Aurelio Santos ◽  
Howard Chan ◽  
Nancy M. Heddle ◽  
...  
Keyword(s):  
Platelet Count ◽  
Mycophenolate Mofetil ◽  
Adverse Events ◽  
Observational Study ◽  
Immune Thrombocytopenic Purpura ◽  
Treatment Options ◽  
Initial Response ◽  
Immunosuppressant Therapy ◽  
Thrombocytopenic Purpura ◽  
Refractory Itp

Abstract Treatment options for patients with chronic refractory immune thrombocytopenic purpura (ITP) are limited. Because combination immunosuppressant therapy appeared to be effective in ITP and other disorders, we used this approach in patients with particularly severe and refractory ITP. In this retrospective, observational study, we determined the response (platelet count above 30 × 109/L and doubling of baseline) among 19 refractory ITP patients. Treatment consisted of azathioprine, mycophenolate mofetil, and cyclosporine. The patients had failed a median of 6 prior treatments, including splenectomy (in all except 1). Of 19 patients, 14 (73.7%) achieved a response lasting a median of 24 months, after which time 8 (57.1%) relapsed. Of the 8 relapsing patients, 6 responded to additional treatments. Of the 14 patients who achieved an initial response, 2 (14.3%) remained in remission after eventually stopping all medications. Severe adverse events did not occur. Combination immunosuppressant therapy can produce a rise in the platelet count that is sometimes sustained in refractory ITP patients.

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