Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

dc.contributor.authorYılmaz, Ünsal
dc.contributor.authorGücüyener, Kıvılcım
dc.contributor.authorYavuz, Merve
dc.contributor.authorÖncel, İbrahim
dc.contributor.authorCanpolat, Mehmet
dc.contributor.authorSaltık, Sema
dc.contributor.authorÜnver, Olcay
dc.contributor.authorÇıtak Kurt, Ayşegül Neşe
dc.contributor.authorTosun, Ayşe
dc.contributor.authorYılmaz, Sanem
dc.contributor.authorÖzgör, Bilge
dc.contributor.authorErol, İlknur
dc.contributor.authorÖztoprak, Ülkühan
dc.contributor.authorElitez, Duygu Aykol
dc.contributor.authorDirek, Meltem Çobanoğulları
dc.contributor.authorBodur, Muhittin
dc.contributor.authorTeber, Serap
dc.contributor.authorAnlar, Banu
dc.description.abstractThe discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series.
dc.description.abstractTo describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015.
dc.description.abstractData of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Türkiye. Clinical and paraclinical features were compared between patients with disease onset before 12 years (earlier onset) and ≥12 years (later onset) as well as between our current (2015-2021) and previous (<2015) cohorts.
dc.description.abstractA total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset <12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort.
dc.description.abstractPediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought.
dc.subjectPediatric multiple sclerosis
dc.titleRe-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.