Table 2. Comparison of Clinical and MRI Characteristics of MOG-IgG, AQP4-IgG, and MS Myelitis.
| Demographics | Myelitis, No./Total No. (%) | MOG-IgG vs AQP4-IgG P Valuea | MS Myelitis, No./Total No. (%) | MOG-IgG vs MS P Valueb | |
|---|---|---|---|---|---|
| MOG-IgG | AQP4-IgG | ||||
| Age (range), y | 25 (3-73) | 49.5 (15-75) | <.001 | 35 (18-59) | .007 |
| Children (<18 y) | 16/54 (30) | 2/46 (4) | .001 | 0/26 | .002 |
| Female | 24/54 (44) | 39/46 (85) | <.001 | 20/26 (77) | .006 |
| White | 50/54 (93) | 32/46 (70) | .003 | 26/26 (100) | .15 |
| Clinical features | |||||
| Preceding viral-like prodrome or vaccination | 33/54 (61) | 3/46 (7) | <.001 | 0/26 | <.001 |
| ADEM with myelitis | 9/54 (17) | 0/46 | .004 | 0/26 | .03 |
| History of intractable nausea and vomiting | 5/54 (9) | 9/46 (20) | .14 | 0/26 | .11 |
| Neurogenic bowel/bladder | 45/54 (83) | 32/46 (69) | .10 | 8/26 (31) | <.001 |
| Erectile dysfunction | 13/24 (54) | 1/7 (14) | .06 | 0/6 | .06 |
| Wheelchair dependent at attack nadir | 18/54 (33) | 15/46 (33) | .94 | 0/26 | <.001 |
| CSF findings | |||||
| CSF elevated white blood cell count, >5 cells/μL | 30/42 (71)c | 21/24 (88) | .13 | 13/18 (72) | .81 |
| Markedly elevated CSF white blood cell count, >50 cells/μL | 22/42 (52) | 6/24 (25) | .03 | 0/18 | <.001 |
| Elevated CSF protein, >50 mg/dL | 30/42 (71) | 16/24 (67) | .69 | 7/18 (39) | .02 |
| Elevated (≥4) oligoclonal bands | 1/38 (3) | 3/27 (11) | .16 | 16/18 (89) | <.001 |
| MRI spine features | |||||
| Longitudinally extensive sagittal T2 lesion (>3 vertebral segments) | 37/47 (79) | 28/34 (82) | .52 | 0/26 | <.001 |
| ≥2 cord lesions | 29/47 (62) | 0/34 | <.001 | 17/26 (65) | .76 |
| Gadolinium enhancement | 14/54 (26) | 31/40 (78) | <.001 | 19/26 (73) | <.001 |
| Concurrent H sign and linear sagittal hyperintensity | 15/51 (29) | 3/39 (8) | .007 | 0/26 | .002 |
| Involvement of conus | 21/51 (41) | 5/38 (13) | .004 | 5/15 (33) | .59 |
| MRI head features | |||||
| Infratentorial lesions | 19/46 (41) | 8/29 (28) | .23 | 9/25 (36) | .66 |
| Deep gray matter lesions | 14/46 (30) | 3/29 (10) | .04 | 1/25 (4) | .009 |
| Inferior temporal periventricular lesions | 3/43 (7) | 2/29 (7) | .95 | 6/25 (24) | .03 |
| Ovoid periventricular | 8/46 (17) | 4/29 (14) | .76 | 9/25 (36) | .08 |
| Gadolinium enhancement | 8/44 (18) | 3/24 (13) | .37 | 13/25 (52) | .003 |
| Clinical outcomes | |||||
| Gait aid at last follow-up | 3/54 (6) | 17/46 (37) | <.001 | 1/26 (4) | .74 |
| mRS at last follow-up, median (range) | 1 (0-4) | 2 (0-6) | <.001 | 1 (0-4) | .61 |
| Duration of follow-up, median (range), mo | 24 (2-120) | 34 (1-118) | .39 | 90 (1-166) | <.001 |
Abbreviations: ADEM, acute disseminated encephalomyelitis; AQP4, aquaporin-4; CSF, cerebrospinal fluid; MOG, myelin oligodendrocyte glycoprotein; MRI, magnetic resonance imaging; mRS, modified Rankin Scale; MS, multiple sclerosis.
SI conversion factor: To convert protein to grams per liter, multiply by 0.01; white blood cell count to ×109/L, multiply by 0.001.
a
Statistical comparison between MOG IgG myelitis and AQP4 IgG myelitis cases.
b
Statistical comparison between MOG IgG myelitis and MS myelitis cases.
c
Median value of 55 cells/μL (range, 0-430: lymphocytic predominance [96%]).