Abstract
BACKGROUND: To explore the clinical value of MOG-IgG serum titer change and duration in predicting the relapse of MOGAD in children. METHODS: The clinical data, imaging data and laboratory examination results of 63 children with MOGAD were analyzed, and the relationship between serum MOG-IgG titer, titer status and disease relapse was examined. RESULTS: (1) 55 children were positive for MOG-IgG serum titers. According to the titer status, there were 24 cases in the transient positive group and 31 cases in the continuous positive group. There were 36 cases in the low MOG-IgG titer group (≤1:32) and 19 cases in the high MOG-IgG titer group (>1:32). Eight cases were children with overlap syndrome. (2) Compared with the transient positive group, the probability of relapsing in the persistent positive group may be higher (χ2 = 4.685, P = 0.030), and the number of relapses may be higher (Z = 2.254, P = 0.024). Persistent positive MOG-IgG titers showed a poor long-term prognosis (Z = 2.490, P = 0.013). The time to negative MOG-IgG titers in the monophasic course group was shorter than that in the relapsing group (P < 0.05). Compared with the low titer group, the high titer group had more cerebrospinal fluid cells (Z = 2.100, P = 0.036), and the high titer group had a longer duration of glucocorticoid use (Z = 3.088, P = 0.002). (3) In multivariate logistic regression, the time of glucocorticoid use was an independent influencing factor of serum MOG-IgG titer at onset (OR: 1.483, 95% CI = 1.105-1.991, P = 0.009), and the EDSS score (prognostic score) at the third year was an independent influencing factor of MOG-IgG titer status (OR: 3.021, 95% CI = 1.030-8.864, P = 0.044). (4) The antibody titer in the monophasic group showed a gradual negative trend, and the titer in the relapsing group fluctuated. CONCLUSIONS: The persistent positive state of MOG-IgG is an important marker of recurrence and poor prognosis. Children with high titers of MOG-IgG at onset or those who do not turn negative within 3 months may be considered to extend the immunotherapy period. Careful examination of the serum titer status and titer of MOG-IgG, combined with clinical data, can guide the clinical further analysis of the prognosis of MOGAD.