PMID- 36274473
OWN - NLM
STAT- MEDLINE
DCOM- 20221114
LR  - 20221114
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 67
DP  - 2022 Nov
TI  - The Prevalence, Demographics, Clinical Features, Neuroimaging, and Inter-ethnic 
      Differences of MOGAD in Malaysia with Global Perspectives.
PG  - 104168
LID - S2211-0348(22)00674-5 [pii]
LID - 10.1016/j.msard.2022.104168 [doi]
AB  - INTRODUCTION: CNS IIDDs(1) tested positive for anti-MOG(2) are known to have a 
      distinct clinical profile with a better overall prognosis. OBJECTIVES: We aim to 
      determine the prevalence, demographic and clinical characteristics of MOG 
      antibody disease (MOGAD) specifically identifying any ethnic variations unique to 
      our local population, with global perspectives. METHODS: This is a 
      cross-sectional study conducted at the Neurology Department, Kuala Lumpur 
      Hospital from January 2018 to January 2021. Out of 750 CNS IIDDs, seventy-eight 
      consecutive anti-AQP4 antibody negative NMOSD/high risk undifferentiated 
      relapsing or monophasic CNSIIDD subjects were tested for anti-MOG. RESULTS: 
      Anti-MOG was positive in thirty six out of seventy-eight (%)(46.1%) seronegative 
      patients. The prevalence of MOGAD in our Malaysian population is 0.12 per 100,000 
      persons with less marked female preponderance of 2:1 and younger age at onset of 
      23.8 +/- 14.4 years. Despite a predominantly ethnic Malay population, a high 
      proportion of our MOGAD patients were Indian (Proportion of 
      Malay:Chinese:Indian:others; 16:9:10:1, prevalence 0.5 per 100,000 population for 
      Indians) with favourable disease course in the most with minor exceptions. 
      Monophasic and relapsing disease course was seen in 11.2% and 88.8% of patients 
      respectively. However, fulminant aggressive disease can occur especially amongst 
      the Chinese and paediatric cohorts. Optic neuritis, NMOSD and ADEM were the 
      commonest presentations at onset and first relapse. EDSS at diagnosis, first 
      relapse, and last follow-up were 4.5+/-2.5, 3+/-2.0, and 1.75(range 1-3). 
      Neuroimaging showed large, fluffy, PRES- like supratentorial cortical, 
      periventricular deep white matter ,diencephalon lesions,enhancing anterior optic 
      nerve with or without chiasmal sparring lesions and cervical/cervicothoracic 
      involvement. Area post rema lesions were rare. Threshold steroid levels exist 
      relapsing on withdrawal some fulminantly requiring Immunosuppressants(rituximab) 
      and intravenous immunoglobulins to maintain remission. CONCLUSION: Malaysian 
      MOGAD profile was similar to its international descriptions of the disease with 
      ethnic selectivity for Indians. Prolonged steroid maintenance is essential to 
      prevent relapses. Fulminant aggressive cases of MOGAD especially amongst 
      Paediatric patients and the Chinese cohort have been reported.
CI  - Copyright (c) 2022. Published by Elsevier B.V.
FAU - Ong, Z M
AU  - Ong ZM
AD  - Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
FAU - Arip, M
AU  - Arip M
AD  - Allergy and Immunology Research Centre, Institute of Medical Research, Kuala 
      Lumpur, Malaysia.
FAU - Ching, Y M
AU  - Ching YM
AD  - Allergy and Immunology Research Centre, Institute of Medical Research, Kuala 
      Lumpur, Malaysia.
FAU - Kumar, L
AU  - Kumar L
AD  - Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
FAU - Terumalay, S
AU  - Terumalay S
AD  - Department of Paediatrics, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
FAU - Sim, S H
AU  - Sim SH
AD  - Borneo Medical Centre, Kuching, Sarawak, Malaysia.
FAU - Adenan, S M
AU  - Adenan SM
AD  - Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
FAU - Viswanathan, S
AU  - Viswanathan S
AD  - Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. 
      Electronic address: shivenda70@yahoo.com.
LA  - eng
PT  - Journal Article
DEP - 20220909
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
RN  - 0 (Aquaporin 4)
RN  - 0 (Autoantibodies)
RN  - 0 (Myelin-Oligodendrocyte Glycoprotein)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Female
MH  - Humans
MH  - Young Adult
MH  - Aquaporin 4
MH  - Autoantibodies
MH  - Cross-Sectional Studies
MH  - Malaysia/epidemiology
MH  - Myelin-Oligodendrocyte Glycoprotein
MH  - Neuroimaging
MH  - *Neuromyelitis Optica
MH  - Prevalence
MH  - Recurrence
MH  - Male
OTO - NOTNLM
OT  - Biomarkers
OT  - Double seronegatives
OT  - Global perspectives
OT  - Myelin Oligodendrocyte Glycoprotein
OT  - Neuromyelitis optica spectrum disorders
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2022/10/25 06:00
MHDA- 2022/11/10 06:00
CRDT- 2022/10/24 03:18
PHST- 2022/04/14 00:00 [received]
PHST- 2022/08/20 00:00 [revised]
PHST- 2022/09/08 00:00 [accepted]
PHST- 2022/10/25 06:00 [pubmed]
PHST- 2022/11/10 06:00 [medline]
PHST- 2022/10/24 03:18 [entrez]
AID - S2211-0348(22)00674-5 [pii]
AID - 10.1016/j.msard.2022.104168 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2022 Nov;67:104168. doi: 10.1016/j.msard.2022.104168. 
      Epub 2022 Sep 9.