PMID- 37547139
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230808
IS  - 1662-4548 (Print)
IS  - 1662-453X (Electronic)
IS  - 1662-453X (Linking)
VI  - 17
DP  - 2023
TI  - Diagnostic challenge in children with an acquired demyelinating syndrome: an 
      illustrative case report.
PG  - 1205065
LID - 10.3389/fnins.2023.1205065 [doi]
LID - 1205065
AB  - The clinical-radiological and biological overlap of the spectrum of pediatric 
      demyelinating disorders makes the diagnostic process of a child with an acquired 
      demyelinating syndrome truly challenging. We present a 9-year-old girl with 
      subacute symptoms of severe decrease in bilateral visual acuity and gait ataxia. 
      An urgent MRI showed inflammatory-demyelinating lesions affecting the 
      periaqueductal gray matter, the cerebellar hemispheres, the area postrema as well 
      as both optic nerves and chiasm. Likewise, multisegmental involvement of the 
      cervical and dorsal spinal cord was found, with short and peripheral lesions. 
      Anti myelin oligodendrocyte glycoprotein (MOG) antibodies (Abs) were positive in 
      cerebrospinal fluid (CSF) and weakly in serum. Oligoclonal bands (OB) were 
      positive in CSF. Based on all this, the diagnosis of MOG antibody disease (MOGAD) 
      with a neuromyelitis optica spectrum disorder (NMOSD)-like picture was made. 
      Given the good clinical and radiological recovery after the acute phase 
      treatment, and that anti MOG Abs became negative, it was decided to keep the 
      patient without specific treatment. However, during follow-up, while the patient 
      was asymptomatic, a control brain MRI showed the appearance of new lesions with 
      morphology and topography suggestive of multiple sclerosis (MS). This, added to 
      the presence of OB, made the diagnosis of pediatric-onset MS (POMS) likely. 
      Immunosuppressive treatment was restarted with a good response since then. Unlike 
      adult-onset MS, children with POMS may usually not have entirely typical clinical 
      and radiological features at presentation. In many cases, the time factor and 
      close clinical and radiological monitoring could be critical to make an accurate 
      diagnosis.
CI  - Copyright (c) 2023 Midaglia, Felipe-Rucian, Delgado Alvarez, Montalban and Tintore.
FAU - Midaglia, Luciana
AU  - Midaglia L
AD  - Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia 
      (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, 
      Barcelona, Spain.
FAU - Felipe-Rucian, Ana
AU  - Felipe-Rucian A
AD  - Seccio de Neurologia Pediatrica, Hospital Universitari Vall d'Hebron, Universitat 
      Autonoma de Barcelona, Barcelona, Spain.
FAU - Delgado Alvarez, Ignacio
AU  - Delgado Alvarez I
AD  - Servei de Radiologia, Hospital Universitari Vall d'Hebron, Universitat Autonoma 
      de Barcelona, Barcelona, Spain.
FAU - Montalban, Xavier
AU  - Montalban X
AD  - Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia 
      (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, 
      Barcelona, Spain.
FAU - Tintore, Mar
AU  - Tintore M
AD  - Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia 
      (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, 
      Barcelona, Spain.
LA  - eng
PT  - Case Reports
DEP - 20230720
PL  - Switzerland
TA  - Front Neurosci
JT  - Frontiers in neuroscience
JID - 101478481
PMC - PMC10399123
OTO - NOTNLM
OT  - MOG antibody-associated disease (MOGAD)
OT  - acquired demyelinating syndrome (ADS)
OT  - multiple sclerosis (MS)
OT  - myelin oligodendrocyte glycoprotein (MOG)
OT  - neuromyelitis optica spectrum disorder (NMOSD)
OT  - pediatric onset multiple sclerosis (POMS)
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/08/07 06:41
MHDA- 2023/08/07 06:42
PMCR- 2023/01/01
CRDT- 2023/08/07 04:48
PHST- 2023/04/13 00:00 [received]
PHST- 2023/07/04 00:00 [accepted]
PHST- 2023/08/07 06:42 [medline]
PHST- 2023/08/07 06:41 [pubmed]
PHST- 2023/08/07 04:48 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fnins.2023.1205065 [doi]
PST - epublish
SO  - Front Neurosci. 2023 Jul 20;17:1205065. doi: 10.3389/fnins.2023.1205065. 
      eCollection 2023.