Frequency and characteristics of MRI-negative myelitis associated with MOG autoantibodies

Elia Sechi; Karl N. Krecke; Sean J. Pittock; Divyanshu Dubey; A. Sebastian Lopez-Chiriboga; Amy Kunchok; Brian G. Weinshenker; Nicholas L. Zalewski; Eoin P. Flanagan

doi:10.1177/1352458520907900

Frequency and characteristics of MRI-negative myelitis associated with MOG autoantibodies

Elia Sechi, Karl N. Krecke, Sean J. Pittock, Divyanshu Dubey, A. Sebastian Lopez-Chiriboga, Amy Kunchok, Brian G. Weinshenker, Nicholas L. Zalewski, Eoin P. Flanagan

Research output: Contribution to journal › Article

Abstract

Background: Myelitis accompanied by a negative spinal cord MRI may lead to diagnostic uncertainty. Objective and Methods: We retrospectively investigated the frequency of negative spinal cord MRI (performed <6 weeks from onset) in Mayo Clinic patients with myelin oligodendrocyte glycoprotein (MOG)-IgG-associated myelitis (2000–2019). Results: The initial spinal cord MRI was negative in 7/73 (10%) patients, despite severe acute disability (median EDSS, 7 (range, 4.5–8)); myelitis symptoms/signs were frequent (paraparesis, neurogenic bladder, sensory level, Lhermitte’s phenomenon). Myelitis lesions became overt at follow-up MRI in three patients. Conclusions: A negative spinal cord MRI should not dissuade from MOG-IgG testing in patients with acute/subacute myelitis.

Original language	English (US)
Journal	Multiple Sclerosis Journal
DOIs	https://doi.org/10.1177/1352458520907900
State	Accepted/In press - Jan 1 2020

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Keywords

acute transverse myelitis
Demyelination
MRI
myelin oligodendrocyte glycoprotein
neuromyelitis optica
T2 lesions

ASJC Scopus subject areas

Neurology
Clinical Neurology

Cite this

Sechi, E., Krecke, K. N., Pittock, S. J., Dubey, D., Lopez-Chiriboga, A. S., Kunchok, A., Weinshenker, B. G., Zalewski, N. L., & Flanagan, E. P. (Accepted/In press). Frequency and characteristics of MRI-negative myelitis associated with MOG autoantibodies. Multiple Sclerosis Journal. https://doi.org/10.1177/1352458520907900

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title = "Frequency and characteristics of MRI-negative myelitis associated with MOG autoantibodies",

abstract = "Background: Myelitis accompanied by a negative spinal cord MRI may lead to diagnostic uncertainty. Objective and Methods: We retrospectively investigated the frequency of negative spinal cord MRI (performed <6 weeks from onset) in Mayo Clinic patients with myelin oligodendrocyte glycoprotein (MOG)-IgG-associated myelitis (2000–2019). Results: The initial spinal cord MRI was negative in 7/73 (10%) patients, despite severe acute disability (median EDSS, 7 (range, 4.5–8)); myelitis symptoms/signs were frequent (paraparesis, neurogenic bladder, sensory level, Lhermitte{\textquoteright}s phenomenon). Myelitis lesions became overt at follow-up MRI in three patients. Conclusions: A negative spinal cord MRI should not dissuade from MOG-IgG testing in patients with acute/subacute myelitis.",

keywords = "acute transverse myelitis, Demyelination, MRI, myelin oligodendrocyte glycoprotein, neuromyelitis optica, T2 lesions",

author = "Elia Sechi and Krecke, {Karl N.} and Pittock, {Sean J.} and Divyanshu Dubey and Lopez-Chiriboga, {A. Sebastian} and Amy Kunchok and Weinshenker, {Brian G.} and Zalewski, {Nicholas L.} and Flanagan, {Eoin P.}",

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doi = "10.1177/1352458520907900",

language = "English (US)",

journal = "Multiple Sclerosis",

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AU - Sechi, Elia

AU - Krecke, Karl N.

AU - Pittock, Sean J.

AU - Dubey, Divyanshu

AU - Lopez-Chiriboga, A. Sebastian

AU - Kunchok, Amy

AU - Weinshenker, Brian G.

AU - Zalewski, Nicholas L.

AU - Flanagan, Eoin P.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: Myelitis accompanied by a negative spinal cord MRI may lead to diagnostic uncertainty. Objective and Methods: We retrospectively investigated the frequency of negative spinal cord MRI (performed <6 weeks from onset) in Mayo Clinic patients with myelin oligodendrocyte glycoprotein (MOG)-IgG-associated myelitis (2000–2019). Results: The initial spinal cord MRI was negative in 7/73 (10%) patients, despite severe acute disability (median EDSS, 7 (range, 4.5–8)); myelitis symptoms/signs were frequent (paraparesis, neurogenic bladder, sensory level, Lhermitte’s phenomenon). Myelitis lesions became overt at follow-up MRI in three patients. Conclusions: A negative spinal cord MRI should not dissuade from MOG-IgG testing in patients with acute/subacute myelitis.

AB - Background: Myelitis accompanied by a negative spinal cord MRI may lead to diagnostic uncertainty. Objective and Methods: We retrospectively investigated the frequency of negative spinal cord MRI (performed <6 weeks from onset) in Mayo Clinic patients with myelin oligodendrocyte glycoprotein (MOG)-IgG-associated myelitis (2000–2019). Results: The initial spinal cord MRI was negative in 7/73 (10%) patients, despite severe acute disability (median EDSS, 7 (range, 4.5–8)); myelitis symptoms/signs were frequent (paraparesis, neurogenic bladder, sensory level, Lhermitte’s phenomenon). Myelitis lesions became overt at follow-up MRI in three patients. Conclusions: A negative spinal cord MRI should not dissuade from MOG-IgG testing in patients with acute/subacute myelitis.

KW - acute transverse myelitis

KW - Demyelination

KW - MRI

KW - myelin oligodendrocyte glycoprotein

KW - neuromyelitis optica

KW - T2 lesions

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10.1177/1352458520907900