Multiple Sclerosis Is Rare in Epstein–Barr Virus–Seronegative Children with Central Nervous System Inflammatory Demyelination

Bardia Nourbakhsh; Christian Cordano; Carlo Asteggiano; Klemens Ruprecht; Carolin Otto; Alice Rutatangwa; Allysa Lui; Janace Hart; Eoin P. Flanagan; Judith A. James; Emmanuelle Waubant

doi:10.1002/ana.26062

Multiple Sclerosis Is Rare in Epstein–Barr Virus–Seronegative Children with Central Nervous System Inflammatory Demyelination

Bardia Nourbakhsh, Christian Cordano, Carlo Asteggiano, Klemens Ruprecht, Carolin Otto, Alice Rutatangwa, Allysa Lui, Janace Hart, Eoin P. Flanagan, Judith A. James, Emmanuelle Waubant

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Although Epstein–Barr virus (EBV) is hypothesized to be a prerequisite for multiple sclerosis (MS), up to 15% of children with a diagnosis of MS were reported to be EBV-seronegative. When re-evaluating 25 EBV-seronegative children out of 189 pediatric patients with a diagnosis of clinically isolated syndrome/MS, we found anti–myelin oligodendrocyte glycoprotein (MOG) antibody in 11 of 25 (44%) EBV-seronegative but only 9 of 164 (5.5%, p < 0.001) EBV-seropositive patients. After critical review, MS remained a plausible diagnosis in only 4 of 14 EBV-seronegative/MOG antibody–negative patients. In children with an MS-like presentation, EBV seronegativity should alert clinicians to consider diagnoses other than MS, especially MOG-antibody disease. ANN NEUROL 2021;89:1234–1239.

Original language	English (US)
Pages (from-to)	1234-1239
Number of pages	6
Journal	Annals of neurology
Volume	89
Issue number	6
DOIs	https://doi.org/10.1002/ana.26062
State	Published - Jun 2021

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1002/ana.26062

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title = "Multiple Sclerosis Is Rare in Epstein–Barr Virus–Seronegative Children with Central Nervous System Inflammatory Demyelination",

abstract = "Although Epstein–Barr virus (EBV) is hypothesized to be a prerequisite for multiple sclerosis (MS), up to 15% of children with a diagnosis of MS were reported to be EBV-seronegative. When re-evaluating 25 EBV-seronegative children out of 189 pediatric patients with a diagnosis of clinically isolated syndrome/MS, we found anti–myelin oligodendrocyte glycoprotein (MOG) antibody in 11 of 25 (44%) EBV-seronegative but only 9 of 164 (5.5%, p < 0.001) EBV-seropositive patients. After critical review, MS remained a plausible diagnosis in only 4 of 14 EBV-seronegative/MOG antibody–negative patients. In children with an MS-like presentation, EBV seronegativity should alert clinicians to consider diagnoses other than MS, especially MOG-antibody disease. ANN NEUROL 2021;89:1234–1239.",

author = "Bardia Nourbakhsh and Christian Cordano and Carlo Asteggiano and Klemens Ruprecht and Carolin Otto and Alice Rutatangwa and Allysa Lui and Janace Hart and Flanagan, {Eoin P.} and James, {Judith A.} and Emmanuelle Waubant",

note = "Publisher Copyright: {\textcopyright} 2021 American Neurological Association.",

year = "2021",

month = jun,

doi = "10.1002/ana.26062",

language = "English (US)",

volume = "89",

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AU - Nourbakhsh, Bardia

AU - Cordano, Christian

AU - Asteggiano, Carlo

AU - Ruprecht, Klemens

AU - Otto, Carolin

AU - Rutatangwa, Alice

AU - Lui, Allysa

AU - Hart, Janace

AU - Flanagan, Eoin P.

AU - James, Judith A.

AU - Waubant, Emmanuelle

PY - 2021/6

Y1 - 2021/6

N2 - Although Epstein–Barr virus (EBV) is hypothesized to be a prerequisite for multiple sclerosis (MS), up to 15% of children with a diagnosis of MS were reported to be EBV-seronegative. When re-evaluating 25 EBV-seronegative children out of 189 pediatric patients with a diagnosis of clinically isolated syndrome/MS, we found anti–myelin oligodendrocyte glycoprotein (MOG) antibody in 11 of 25 (44%) EBV-seronegative but only 9 of 164 (5.5%, p < 0.001) EBV-seropositive patients. After critical review, MS remained a plausible diagnosis in only 4 of 14 EBV-seronegative/MOG antibody–negative patients. In children with an MS-like presentation, EBV seronegativity should alert clinicians to consider diagnoses other than MS, especially MOG-antibody disease. ANN NEUROL 2021;89:1234–1239.

AB - Although Epstein–Barr virus (EBV) is hypothesized to be a prerequisite for multiple sclerosis (MS), up to 15% of children with a diagnosis of MS were reported to be EBV-seronegative. When re-evaluating 25 EBV-seronegative children out of 189 pediatric patients with a diagnosis of clinically isolated syndrome/MS, we found anti–myelin oligodendrocyte glycoprotein (MOG) antibody in 11 of 25 (44%) EBV-seronegative but only 9 of 164 (5.5%, p < 0.001) EBV-seropositive patients. After critical review, MS remained a plausible diagnosis in only 4 of 14 EBV-seronegative/MOG antibody–negative patients. In children with an MS-like presentation, EBV seronegativity should alert clinicians to consider diagnoses other than MS, especially MOG-antibody disease. ANN NEUROL 2021;89:1234–1239.

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Multiple Sclerosis Is Rare in Epstein–Barr Virus–Seronegative Children with Central Nervous System Inflammatory Demyelination

Abstract

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