Original articleClinical features in very early-onset demyelinating disease with anti-MOG antibody

BackgroundThe clinical features of patients with very early-onset acquired demyelinating syndrome (ADS) with the anti-myelin oligodendrocyte glycoprotein (MOG) antibody are unknown. We investigated the clinical characteristics and described detailed treatment of weekly intramuscular interferon β-1a (IFNβ-1a) in children aged <4 years with ADS and the anti-MOG antibody.MethodsWe conducted a retrospective chart review of patients with anti-MOG positivity who were diagnosed as having multiple sclerosis (MS) at <4 years of age.ResultsSubjects comprised 2 boys and 2 girls. Initial symptoms included ataxia, facial paresis, status epilepticus, and encephalopathy. Abnormal lesions on magnetic resonance imaging scans were often detected in the brainstem and cerebellum as well as the cerebrum. All patients started receiving IFNβ-1a at age 3.1-3.5 years. The initial doses ranged from 3 to 6 μg, which were 1/10-1/5 doses, respectively, for adults. During 0.6-4.3 years of IFNβ-1a administration, all patients had flu-like symptoms, and 1 patient had an increased liver enzyme level. Although 1 patient discontinued IFNβ-1a therapy because of frequent relapses, no patient discontinued therapy due to severe adverse events.ConclusionsThis case series adds novel information regarding the clinical features of children <4 years old with ADS and the anti-MOG antibody.