Choroba związana z przeciwciałami białka mieliny oligodendrocytów (mogad)

Choroba związana z przeciwciałami białka mieliny oligodendrocytów (mogad)
Charakterystyka, pielęgnacja i opieka

Choroba związana z przeciwciałami białka mieliny oligodendrocytów (MOGAD) to rzadka, autoimmunologiczna choroba zapalna OUN, charakteryzująca się demielinizacją w mózgu, rdzeniu kręgowym i nerwach wzrokowych. W fazie ostrej leczenie opiera się na dożylnych kortykosteroidach (metylprednizolon 1000 mg/dobę u dorosłych lub 20-30 mg/kg/dobę u dzieci przez 5 dni), a w ciężkich przypadkach stosuje się plazmaferezę (5-7 cykli co drugi dzień) lub dożylne immunoglobuliny (2 g/kg przez 2-5 dni). Około 40-50% pacjentów doświadcza nawrotów, co wymaga długoterminowej immunosupresji, najczęściej z użyciem IVIG (około 70% remisji) lub leków doustnych, takich jak mykofenolan mofetylu czy azatiopryna, które jednak zwiększają ryzyko infekcji dróg oddechowych i moczowych. Opieka pielęgniarska obejmuje monitorowanie objawów nawrotu, wsparcie rehabilitacyjne, zarządzanie powikłaniami neurologicznymi (utrata wzroku, spastyczność, ból neuropatyczny, dysfunkcje pęcherza i jelit) oraz wsparcie psychologiczne.

Rola pielęgniarstwa w chorobie związanej z przeciwciałami białka mieliny oligodendrocytów (MOGAD)

Rozpoznanie kliniczne i opieka w fazie ostrej
Opieka długoterminowa i zapobieganie nawrotom
Holistyczne podejście do opieki nad pacjentem z MOGAD
Strategie radzenia sobie z objawami i powikłaniami

Edukacja pacjenta i wsparcie w MOGAD

Monitorowanie i ocena skuteczności leczenia
Specjalne konsyderacje w opiece nad dziećmi z MOGAD

Szczególne wyzwania w opiece nad pacjentami z MOGAD

Rozróżnienie między MOGAD a innymi chorobami demielinizacyjnymi
Opieka nad pacjentami z immunosupresją
Opieka nad kobietami w wieku rozrodczym
Wsparcie psychologiczne i emocjonalne

Przyszłość opieki pielęgniarskiej w MOGAD

Znaczenie standaryzacji kryteriów diagnostycznych
Edukacja i rzecznictwo

Podsumowanie roli pielęgniarskiej w MOGAD

Kolejne rozdziały

Rola pielęgniarstwa w chorobie związanej z przeciwciałami białka mieliny oligodendrocytów (MOGAD)

Choroba związana z przeciwciałami białka mieliny oligodendrocytów (MOGAD) to rzadka autoimmunologiczna choroba zapalna ośrodkowego układu nerwowego, która wymaga kompleksowej opieki pielęgniarskiej ze względu na swój zmienny przebieg i potencjalne powikłania neurologiczne. W MOGAD układ odpornościowy atakuje białko mieliny oligodendrocytów (MOG), powodując demielinizację włókien nerwowych w mózgu, rdzeniu kręgowym i nerwach wzrokowych.¹² Opieka pielęgniarska odgrywa kluczową rolę zarówno w fazie ostrej choroby, jak i w długoterminowym postępowaniu z pacjentami z MOGAD.

Rozpoznanie kliniczne i opieka w fazie ostrej

Pielęgniarki powinny być zaznajomione z różnorodnymi objawami MOGAD, które mogą obejmować utratę wzroku, ból oczu, osłabienie mięśni, drętwienie, mrowienie, ból, paraliż i zwiększoną wrażliwość na dotyk.¹ Typowe manifestacje kliniczne MOGAD to zapalenie nerwu wzrokowego (pojedynczego lub obustronne), zapalenie rdzenia kręgowego, ostre rozsiane zapalenie mózgu i rdzenia (ADEM) oraz zapalenie kory mózgowej.¹ Personel pielęgniarski powinien zwracać szczególną uwagę na obecność objawów prodromalnych, gdyż infekcja może poprzedzać wystąpienie MOGAD.¹

W fazie ostrej ataki MOGAD są zazwyczaj ciężkie i wymagają natychmiastowego leczenia dla uzyskania jak najpełniejszego powrotu do zdrowia.¹ Pielęgniarki odgrywają kluczową rolę w administrowaniu leków, monitorowaniu stanu pacjenta i wykrywaniu potencjalnych skutków ubocznych terapii. Podawanie dożylnych kortykosteroidów (metylprednizolon 1000 mg u dorosłych lub 20-30 mg/kg/dzień u dzieci) przez pięć kolejnych dni stanowi podstawę leczenia ostrego.¹² W ciężkich przypadkach lub przy braku odpowiedzi na kortykosteroidy może być konieczne zastosowanie plazmaferezy (5-7 cykli co drugi dzień) lub dożylnych immunoglobulin (łącznie 2 g/kg przez 2 lub 5 dni).¹

Opieka długoterminowa i zapobieganie nawrotom

Chociaż MOGAD może mieć przebieg jednofazowy (monofazowy), około 40-50% pacjentów doświadcza nawrotów.¹² Pielęgniarki powinny edukować pacjentów na temat znaczenia długoterminowego monitorowania i przestrzegania zaleconego schematu leczenia. Dla pacjentów z nawracającym MOGAD, dostępne opcje leczenia zapobiegawczego obejmują doustne leki immunosupresyjne (takie jak mykofenolan mofetylu, azatiopryna) oraz leki podawane dożylnie.¹

Badania retrospektywne wykazały, że immunoglobulina dożylna (IVIG) jest najskuteczniejszym leczeniem zapobiegawczym w MOGAD, przy czym około 70% pacjentów osiąga remisję.¹ Mykofenolan mofetylu (CellCept) również wykazał skuteczność w zmniejszaniu rocznego wskaźnika nawrotów w obserwacyjnych badaniach retrospektywnych.¹ Jednakże, wszystkie te leki, z wyjątkiem immunoglobulin (IVIG lub SCIG), wiążą się z ryzykiem infekcji, szczególnie górnych dróg oddechowych i układu moczowego.¹

Holistyczne podejście do opieki nad pacjentem z MOGAD

Kompleksowa opieka nad pacjentem z MOGAD wymaga multidyscyplinarnego zespołu, w którym pielęgniarki stanowią istotne ogniwo. W skład zespołu opieki mogą wchodzić: neurolodzy, neuro-okuliści, neuro-urolodzy, koordynatorzy pielęgniarki, pracownicy socjalni, terapeuci zajęciowi i psycholodzy.¹ Pielęgniarki pomagają pacjentom w dostępie do potrzebnych usług i wsparcia, co jest szczególnie ważne w przypadku tej rzadkiej choroby.¹

Opieka pielęgniarska w MOGAD powinna obejmować następujące aspekty:

Monitorowanie objawów nawrotu – pielęgniarki powinny edukować pacjentów o rozpoznawaniu wczesnych objawów nawrotu, takich jak zmiany widzenia, nowe objawy neurologiczne czy problemy z poruszaniem się¹²
Wsparcie w rehabilitacji – pacjenci mogą potrzebować pomocy w nauce jak wykonywać codzienne czynności i poruszać się samodzielnie, jeśli uszkodzenie mieliny wpływa na ich wzrok i ruch¹
Zarządzanie powikłaniami – pielęgniarki pomagają w leczeniu powikłań, takich jak zaburzenia widzenia, trudności w poruszaniu się, utrata kontroli nad pęcherzem lub jelitami oraz ból neuropatyczny¹²
Wsparcie psychologiczne – życie z MOGAD może być trudne i prowadzić do depresji; pielęgniarki powinny być wyczulone na oznaki problemów ze zdrowiem psychicznym¹²

Strategie radzenia sobie z objawami i powikłaniami

Pielęgniarki odgrywają kluczową rolę w pomaganiu pacjentom w radzeniu sobie z objawami i powikłaniami MOGAD, które mogą obejmować:

Utratę wzroku lub zaburzenia widzenia – wsparcie w korzystaniu z pomocy dla osób z zaburzeniami wzroku, współpraca ze specjalistami rehabilitacji wzroku¹²
Spastyczność – edukacja na temat leków przeciwdrgawkowych, technik rozciągania i terapii fizykalnej¹
Ból neuropatyczny – pomoc w zarządzaniu bólem poprzez odpowiednie stosowanie leków i niefarmakologicznych metod łagodzenia bólu¹²
Problemy z pęcherzem i jelitami – edukacja na temat technik samokateteryzacji, reżimów wypróżniania i zarządzania funkcjami pęcherza¹²
Zmęczenie – strategie oszczędzania energii, planowanie aktywności i odpowiedniego odpoczynku¹

Edukacja pacjenta i wsparcie w MOGAD

Edukacja pacjenta jest kluczowym elementem opieki pielęgniarskiej w MOGAD. Pielęgniarki powinny zapewnić pacjentom i ich rodzinom zrozumiałe informacje na temat choroby, dostępnych opcji leczenia i strategii radzenia sobie z objawami. Niestety, badania wskazują, że większość respondentów (60,6%) czuje, że nie otrzymali wystarczających informacji i/lub zasobów w momencie diagnozy MOGAD.¹

Kluczowe obszary edukacji pacjenta obejmują:

Zrozumienie natury choroby jako zaburzenia autoimmunologicznego, w którym przeciwciała atakują białko MOG w osłonce mielinowej¹
Rozpoznawanie objawów nawrotu i znaczenie wczesnego zgłaszania ich personelowi medycznemu¹
Właściwe stosowanie leków i rozpoznawanie potencjalnych skutków ubocznych¹
Zrozumienie potrzeby okresowego monitorowania za pomocą badań MRI, testów krwi i badań¹
Dostęp do zasobów wsparcia i grup wsparcia dla pacjentów z MOGAD¹

Pielęgniarki mogą pomóc pacjentom w radzeniu sobie ze stresem związanym z życiem z MOGAD poprzez zachęcanie do utrzymywania normalnych codziennych aktywności na ile to możliwe, podtrzymywania kontaktów z przyjaciółmi i rodziną oraz kontaktu z grupami wsparcia.¹

Monitorowanie i ocena skuteczności leczenia

Monitorowanie odpowiedzi na leczenie jest kluczowe w zarządzaniu MOGAD. Pielęgniarki uczestniczą w regularnej ocenie stanu pacjenta, która może obejmować:¹

Badania MRI w celu monitorowania zmian demielinizacyjnych
Optyczną koherentną tomografię do oceny uszkodzeń nerwu wzrokowego
Pomiar miana przeciwciał MOG
Ocenę funkcji neurologicznych, w tym wzroku, siły mięśniowej i koordynacji
Monitorowanie funkcji pęcherza i jelit

Pielęgniarki powinny również być wyczulone na potencjalne skutki uboczne długoterminowej immunosupresji, takie jak zwiększone ryzyko infekcji czy rozwoju nowotworów. Pacjenci poddawani przewlekłej immunosupresji za pomocą mykofenolanu mofetylu wymagają regularnych badań skóry u dermatologa.¹

Specjalne konsyderacje w opiece nad dziećmi z MOGAD

MOGAD występuje częściej u dzieci niż u dorosłych i może prezentować się inaczej w populacji pediatrycznej.¹ Najczęstszym początkowym fenotypem u dzieci jest ADEM, które często jest poprzedzone infekcją systemową, taką jak infekcja dróg oddechowych lub choroba żołądkowo-jelitowa.¹²

Opieka pielęgniarska nad dziećmi z MOGAD powinna uwzględniać:

Dostosowanie dawek leków do wieku i masy ciała dziecka¹
Wsparcie rodziny i edukację opiekunów¹
Współpracę z pediatrycznymi specjalistami neuroimmunologii, immunologami, specjalistami chorób zakaźnych, okulistami, psychologami, fizjoterapeutami i specjalistami edukacji¹
Monitorowanie rozwoju dziecka i wsparcie w powrocie do normalnych aktywności edukacyjnych i społecznych¹

Na szczęście dzieci z MOGAD mają zazwyczaj lepsze rokowanie niż dorośli, z mniejszą długoterminową niepełnosprawnością.¹ Większość dzieci doświadcza pełnego powrotu do zdrowia, a badania sugerują, że 75%-96% pediatrycznych pacjentów osiąga całkowitą remisję.¹

Szczególne wyzwania w opiece nad pacjentami z MOGAD

Opieka nad pacjentami z MOGAD wiąże się z pewnymi wyzwaniami, które wymagają specjalnego podejścia pielęgniarskiego:

Rozróżnienie między MOGAD a innymi chorobami demielinizacyjnymi

MOGAD jest często błędnie diagnozowane jako inna choroba atakująca mielinę i powodująca podobne objawy, jak stwardnienie rozsiane (MS) lub zaburzenia ze spektrum neuromyelitis optica (NMOSD).¹ Pielęgniarki muszą być świadome różnic między tymi schorzeniami, gdyż mogą one wymagać różnych podejść terapeutycznych. MOGAD różni się od MS i NMOSD tym, że pierwszy atak MOGAD jest zazwyczaj najcięższy, ale pacjenci mogą osiągnąć pełne wyzdrowienie.¹

Badania wykazały, że konwencjonalne metody leczenia MS nie są skuteczne i mogą powodować niepożądane reakcje u pacjentów z MOGAD.¹ Pielęgniarki powinny być czujne na oznaki braku odpowiedzi na leczenie lub pogorszenia stanu, które mogą sugerować błędną diagnozę.

Opieka nad pacjentami z immunosupresją

Długotrwałe leczenie immunosupresyjne stosowane w zapobieganiu nawrotom MOGAD wiąże się z ryzykiem infekcji. Pielęgniarki muszą edukować pacjentów na temat rozpoznawania wczesnych objawów infekcji i znaczenia szybkiego szukania pomocy medycznej. Szczególnie ważne jest monitorowanie zakażeń górnych dróg oddechowych i układu moczowego.¹

Regularne badania skóry są również istotne dla pacjentów leczonych mykofenolanem mofetylu, gdyż przewlekła immunosupresja może zwiększać ryzyko rozwoju nowotworów skóry.¹

Opieka nad kobietami w wieku rozrodczym

MOGAD dotyka kobiety w wieku rozrodczym, co oznacza, że pacjentki mogą wymagać interwencji w okresie przed ciążą, w trakcie ciąży lub po porodzie.¹ Pielęgniarki powinny zapewnić odpowiednie poradnictwo w zakresie planowania rodziny oraz współpracować z zespołem medycznym w celu dostosowania planu leczenia do potrzeb kobiet w ciąży lub karmiących piersią.

Wsparcie psychologiczne i emocjonalne

Życie z MOGAD może być trudne i prowadzić do depresji oraz innych problemów ze zdrowiem psychicznym.¹² Pielęgniarki powinny być wyczulone na oznaki problemów psychologicznych i zapewniać odpowiednie wsparcie. Zachęcanie do utrzymywania normalnych codziennych aktywności, podtrzymywania kontaktów społecznych i korzystania z grup wsparcia może pomóc w radzeniu sobie ze stresem związanym z chorobą.¹

Przyszłość opieki pielęgniarskiej w MOGAD

MOGAD jest stosunkowo nową jednostką chorobową, a wiedza na jej temat szybko się rozwija. Pielęgniarki powinny być na bieżąco z najnowszymi badaniami i wytycznymi dotyczącymi diagnostyki i leczenia tego schorzenia.¹

Obecnie trwają badania kliniczne nad nowymi terapiami, takimi jak satralizumab, które mogą otworzyć nowe możliwości leczenia MOGAD.¹² Pielęgniarki będą odgrywać kluczową rolę w edukacji pacjentów na temat tych nowych opcji terapeutycznych oraz w monitorowaniu ich skuteczności i bezpieczeństwa.

Rozwój multidyscyplinarnych klinik specjalizujących się w leczeniu MOGAD, takich jak Klinika MOGAD w Mayo Clinic, stwarza nowe możliwości dla specjalistycznych ról pielęgniarskich w kompleksowej opiece nad pacjentami z tym schorzeniem.¹²

Znaczenie standaryzacji kryteriów diagnostycznych

Niedawno zaproponowane kryteria diagnostyczne dla MOGAD mogą poprawić identyfikację osób z tym schorzeniem, co usprawni definiowanie długoterminowych wyników klinicznych, udoskonali kryteria włączenia do badań klinicznych i pomoże w identyfikacji czynników predykcyjnych nawracającego lub jednofazowego przebiegu choroby.¹ Pielęgniarki powinny znać te kryteria, aby pomóc w identyfikacji potencjalnych przypadków MOGAD i skierowaniu pacjentów do odpowiednich specjalistów.

Edukacja i rzecznictwo

Ze względu na rzadkość MOGAD, wielu pacjentów napotyka na trudności w uzyskaniu diagnozy i odpowiedniej opieki. Pielęgniarki mogą odgrywać ważną rolę w podnoszeniu świadomości na temat tej choroby wśród pracowników służby zdrowia oraz w rzecznictwie na rzecz lepszego dostępu do specjalistycznej opieki dla pacjentów z MOGAD.¹

Poprzez zaangażowanie w edukację pacjentów, badania i rozwój kliniczny, pielęgniarki mogą znacząco przyczynić się do poprawy opieki nad osobami z MOGAD i ostatecznie do poprawy ich jakości życia.

Podsumowanie roli pielęgniarskiej w MOGAD

Rola pielęgniarstwa w opiece nad pacjentami z chorobą związaną z przeciwciałami białka mieliny oligodendrocytów (MOGAD) jest wszechstronna i kluczowa dla uzyskania optymalnych wyników leczenia. Obejmuje ona:

Rozpoznawanie objawów i pomoc w procesie diagnostycznym
Administrowanie leków w fazie ostrej choroby i monitorowanie ich skuteczności
Edukację pacjentów na temat choroby, dostępnych opcji leczenia i strategii radzenia sobie z objawami
Wsparcie w rehabilitacji i powrocie do codziennych aktywności
Zarządzanie objawami i powikłaniami, takimi jak problemy z widzeniem, spastyczność, ból neuropatyczny, problemy z pęcherzem i jelitami oraz zmęczenie
Zapewnienie wsparcia psychologicznego i emocjonalnego
Monitorowanie długoterminowej skuteczności leczenia i ewentualnych skutków ubocznych
Rzecznictwo na rzecz pacjentów i podnoszenie świadomości na temat MOGAD

Poprzez kompleksowe podejście do opieki, skoncentrowane na pacjencie i jego potrzebach, pielęgniarki mogą znacząco przyczynić się do poprawy jakości życia osób z MOGAD, pomagając im w radzeniu sobie z tą rzadką chorobą autoimmunologiczną.¹²

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Materiały źródłowe

#1 MOGAD: What It Is, Diagnosis, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune condition where your immune system attacks proteins in the protective cover around your nerves (myelin). It causes symptoms that affect your eyes, brain and spinal cord, like vision loss, confusion and muscle weakness. Treatment options are available. […] MOGAD is a relatively rare demyelinating disorder. As awareness increases, healthcare providers expect numbers to increase. It affects an estimated 1 to 3 people per million each year. […] Symptoms of MOGAD affect different parts of your body, including your eyes, spinal cord and brain. […] MOGAD symptoms come and go. You may experience periods without any symptoms before symptoms appear again (relapse). […] It can be difficult to live with and manage MOGAD on your own. When symptoms happen, it can pull you away from activities you enjoy and leave you feeling helpless. Because of this, many people experience depression with MOGAD.
#1 MOG Antibody-Associated Disease | Henry Ford Health – Detroit, MI
https://www.henryford.com/services/neuroinflammatory-disorders-and-ms/neuroinflammatory-diseases-we-treat/mog-antibody-associated-disease
MOG antibody-associated disease is a rare condition that occurs when your immune system attacks parts of the nervous system. […] Symptoms from MOG antibody attacks include: Eye pain, blurry vision, vision loss and blind spots, Muscle weakness, Numbness, tingling and a pins-and-needles sensation, Pain, Paralysis, Severe sensitivity to touch. […] Repeated attacks or ones that last a long time put you at risk for complications such as: Difficulty moving your body and completing basic tasks, Loss of bladder or bowel control, Nerve (neuropathic) pain, which may feel like burning, shooting or stabbing, Unusual muscle stiffness (spasticity). […] Neurologists with advanced training and a depth of experience in inflammatory disorders deliver research-based care for people with MOGAD. […] MOG antibody attack treatment involves high doses of steroids through a vein in your arm (infusion).
#1 Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): A Review of Clinical and MRI Features, Diagnosis, and Management
https://pmc.ncbi.nlm.nih.gov/articles/PMC9247462/
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is the most recently defined inflammatory demyelinating disease of the central nervous system (CNS). […] The clinical manifestations of MOGAD are heterogeneous, ranging from isolated optic neuritis or myelitis to multifocal CNS demyelination often in the form of acute disseminated encephalomyelitis (ADEM), or cortical encephalitis. […] A relapsing course is observed in approximately 50% of patients. […] Although randomized controlled trials are lacking, MOGAD acute attacks appear to be very responsive to high dose steroids and plasma exchange may be considered in refractory cases. […] Attack-prevention treatments also lack class-I data and empiric maintenance treatment is generally reserved for relapsing cases or patients with severe residual disability after the presenting attack.
#1 Review: Myelin Oligodendrocyte Glycoprotein Antibody Disease
https://www.brighamhealthonamission.org/2023/06/14/review-myelin-oligodendrocyte-glycoprotein-antibody-disease/
Various demyelinating diseases, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis (ADEM), and cerebral cortical encephalitis, are now recognized as a spectrum of diseases associated with high titers of autoantibodies that target myelin oligodendrocyte glycoprotein (MOG). They are collectively termed MOG antibody disease (MOGAD). […] MOGAD overlaps somewhat with multiple sclerosis (MS) and neuromyelitis optica spectrum disease (NMOSD) but has distinct clinical, radiologic, and laboratory features. […] The most common presentations of MOGAD are bilateral optic neuritis, transverse myelitis, or ADEM. […] 50% to 60% of patients with MOGAD experience a relapsing course associated with persistently high titers of MOG-IgG. […] An infectious prodrome occurs at least once during the disease course in 37% to 70% of MOGAD patients.
#1 Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/mogad/diagnosis-treatment/drc-20560477
Attacks for MOGAD are usually severe and should be treated right away for the most complete recovery. […] Treatment options may include corticosteroids, plasma exchange, and IV immune globulin. […] Treating symptoms of MOGAD can help reduce pain and side effects after attacks. […] Since MOGAD is a recently discovered disease, there are no proven treatments to prevent attacks. […] Treatment options may include oral immunosuppressants and IV medicines. […] The type of prevention treatment you have affects how long you need the treatment. […] Living with any illness can be difficult. To manage the stress of living with MOGAD, consider these suggestions: Maintain normal daily activities as best you can, stay connected to friends and family, and contact a support group.
#1 Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): Treatment and prognosis – UpToDate
https://www.uptodate.com/contents/myelin-oligodendrocyte-glycoprotein-antibody-associated-disease-mogad-treatment-and-prognosis/print
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory disorder of the central nervous system characterized by attacks of immune-mediated demyelination predominantly targeting the optic nerves, brain, and spinal cord. The treatment and prognosis of MOGAD are reviewed here. […] Treatment of MOGAD can be stratified by acute attack treatment and attack prevention strategies. […] Since acute attacks of MOGAD tend to be severe, almost all are treated. Starting acute treatment as quickly as possible is a good strategy, as some evidence suggests that early treatment of acute attacks with glucocorticoids may reduce the risk of relapse and prevent residual damage. […] We suggest initial treatment with high-dose intravenous (IV) methylprednisolone (1000 mg in adults, or 20 to 30 mg/kg per day in children) for five consecutive days.
#1 Myelin Oligodendrocyte Glycoprotein-Antibody Associated Disease: An Updated Review of the Clinical Spectrum, Pathogenetic Mechanisms and Therapeutic Management
https://www.mdpi.com/2073-4468/13/2/43
Randomized clinical trials, standardized diagnostic criteria and treatment guidelines are the steps forward. […] MOGAD can occur at any age; however, the incidence is higher in children compared to adults when compared to MS and AQP4 + NMOSD, with MOGAD being a more frequent cause of a first demyelinating episode in children than in adults. […] MOGAD associated syndromes are summarized in Table 1. […] Patients with severe symptoms can improve dramatically only after a short course of intravenous steroids. […] It is recommended that a 3â5-day course of 1g of intravenous methylprednisolone should be given depending on the severity and the response of the attack. […] In severe cases, or in those who will not improve after 5 days, escalation to plasma exchange (5â7 cycles on alternative days), intravenous immunoglobulins (total of 2 g/kg over 2 or 5 days), or plasma exchange followed by intravenous immunoglobulins can be considered.
#1 Myelin-oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) – Child Neurology Foundation
https://www.childneurologyfoundation.org/disorder/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad/
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune disease. It affects the nerves in the brain and spinal cord. MOGAD occurs suddenly. It often follows a viral infection. […] Most children have a very good recovery with treatment. […] MOGAD occurs more commonly in children than in adults. It affects males and females equally. […] The treatment is planned with a child neurologist. The treatment for an acute attack may be any combination of the following: […] Depending on the severity of the attack, some children might require intubation and/or a feeding tube. […] Most children with ADEM will have a complete recovery. However, sometimes the lesions on the MRI will not completely resolve. […] MOGAD may only happen once, or it may be relapsing. Relapses are most common in the first six months after the first attack. Relapses are also more common if MOG antibodies are positive. […] Because many people only have MOGAD once, maintenance therapy is typically not started at first. If someone has multiple relapses, long-term treatment options may be considered.
#1 Myelin Oligodendrocyte Glycoprotein-Antibody Associated Disease: An Updated Review of the Clinical Spectrum, Pathogenetic Mechanisms and Therapeutic Management
https://www.mdpi.com/2073-4468/13/2/43
Although randomized-controlled clinical trials have not been conducted, patients with MOGAD who are not considered high risk for relapse are given oral steroids (prednisolone 1g/kg/day) for 3 months followed by prolonged tapering (3 months). […] Data from retrospective studies have shown that intravenous immunoglobulin is the most effective preventive treatment option in MOGAD, with around 70% of the patients achieving remission. […] The field of MOGAD is rapidly evolving.
#1 MOG Antibody Disease (MOGAD) | Prognosis & Management | SRNA
https://wearesrna.org/living-with-myelitis/disease-information/mog-antibody-disease/prognosis-management/
What is MOGAD? […] Those with MOG antibody disease should consider ongoing treatment with medications that suppress the immune system. […] The primary therapies used in the US are mycophenolate mofetil (CellCept), rituximab (Rituxan), azathioprine (Imuran), and repeated IVIG infusions or subcutaneous immunoglobulin. […] All of these medications, with the exception of immunoglobulins (IVIG or SCIG), carry a risk of infections, particularly upper respiratory infections and urinary tract infections (UTIs). […] Chronic immunosuppression with mycophenolate mofetil requires regular skin exams with a dermatologist since our immune system is our best defense against cancer cells developing, and any of these treatments can interfere with its normal functioning. […] Mycophenolate treatment of MOGAD was associated with a reduction of annualized relapse rates in retrospective observational studies.
#1 Neuromyelitis Optica & MOG Antibody Disorder Treatment & Research Program | NYU Langone Health
https://nyulangone.org/care-services/multiple-sclerosis-comprehensive-care-center/neuromyelitis-optica-mog-antibody-disorder-treatment-research-program
Myelin oligodendrocyte glycoprotein antibody associated disorder (MOGAD) is a recently described autoimmune disease that may resemble NMOSD, but requires a different treatment. […] Care for people with NMOSD and MOGAD is provided by our dedicated team, which includes neurologists, neuro-ophthalmologists, a neuro-urologist, nurse coordinators, social workers, occupational therapists, and psychologists. […] For MOGAD relapse prevention, there are no FDA-approved treatments. Several medications are used off label, including intravenous immunoglobulins, subcutaneous immunoglobulins, and oral immunosuppressant drugs such as mycophenolate mofetil (CellCept). Our center is currently participating in a clinical trial, which, if successful, could lead to approval of the first drug for MOGAD. […] People with NMOSD and MOGAD may experience symptoms caused by damage to the nervous tissue. A variety of medications, as well as non-medication approaches, are available to alleviate common symptoms of these diseases.
#1 MOG Antibody-Associated Disease | Henry Ford Health – Detroit, MI
https://www.henryford.com/services/neuroinflammatory-disorders-and-ms/neuroinflammatory-diseases-we-treat/mog-antibody-associated-disease
Care may also include immunosuppressants, drugs that quiet immune system activity. These drugs lower the likelihood of future attacks. […] You may benefit from seeing additional specialists who help prevent and manage complications, including: Neuro-ophthalmologists care for optic nerve concerns, Pain medicine doctors perform procedures that reduce stubborn pain, Neurorehabilitation therapists and physiatrists (physical medicine and rehabilitation doctors) deliver services that relieve spasticity and optimize your abilities, Vision rehabilitation specialists help you cope with low vision and vision loss. […] After your first MOG antibody attack, it can be challenging to determine whether you have monophasic or relapsing disease. This is why monitoring is essential. You undergo periodic MRIs, blood testing and exams. […] Our team nurse helps you access the services and support you need.
#1 MOGAD: What It Is, Diagnosis, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/myelin-oligodendrocyte-glycoprotein-antibody-disease-mogad
There isnt a cure available for MOGAD at this time. […] Treatment for the sudden onset of MOGAD symptoms (acute) includes: Steroids (methylprednisolone), given intravenously (through a vein in your arm) for three to five days. […] Long-term treatment to prevent MOGAD symptom relapses include: Immunosuppressant medications. […] Your provider may recommend participating in rehabilitation programs if complications arise. Rehabilitation can help you learn how to complete your daily routine and move around independently if myelin damage affects your vision and physical movement. […] There isnt a way to prevent MOGAD. Research is ongoing to learn more. […] Most often, people have a good outlook. You might experience permanent changes to your vision. […] You know your body best. If something doesnt seem right, reach out to your provider.
#1 MOG Antibody Disease Information – MyMyelitis
https://mymyelitis.com/mog-antibody-disease/information/
Depending on how badly the disabilities and symptoms affect a person, some lifestyle complications may arise. […] Those with optic neuritis may experience residual vision loss due to the MOGAD attack. […] Spasticity is the stiffness or spasms in our muscles often caused by a spinal cord attack. […] Neuropathic pain can be described in many ways, including burning, stabbing, tingling, or constricting. […] Another complication of spinal cord inflammation caused by MOG Antibody Disease is bladder and bowel issues. […] Fatigue is when you lack physical or mental energy and can be an issue when dealing with/recovering from MOG Antibody Disease. […] Many people find that being diagnosed with MOG Antibody Disease has a damaging effect on their and their family’s mental health.
#1
https://link.springer.com/article/10.1007/s40120-023-00474-9
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare demyelinating disorder of the central nervous system. […] Despite antibody testing, MOGAD diagnosis can remain challenging due to its heterogeneous disease course and low awareness of MOGAD among healthcare professionals. […] This survey revealed that many patients faced a protracted and multi-step pathway towards MOGAD diagnosis, although it is likely that some of these patients sought diagnoses before MOG antibody testing was available. […] This survey provides important insights into the patient and caregiver perspectives of the challenges associated with the diagnosis of MOGAD to help facilitate improvement of the diagnostic pathway. […] Most respondents (60.6%) felt they were not given sufficient information and/or resources at the time of MOGAD diagnosis. […] Receiving an alternative primary diagnosis and delay to final MOGAD diagnosis were associated with increased frustration, physical impairment and reduced health-related quality of life.
#1 MOG Antibody Disease Information – MyMyelitis
https://mymyelitis.com/mog-antibody-disease/information/
Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease or MOG Antibody Disease (MOGAD) is a condition that causes inflammation to the optic nerve(s), brain, and spinal cord. […] MOG antibodies mistakenly attack MOG and the myelin sheath, causing inflammation to the optic nerve(s), spinal cord, and brain. […] In MOG Antibody Disease, the body generates antibodies that attack the MOG proteins and the myelin sheath, damaging the nerves beneath it. […] Symptoms of MOG Antibody disease can present differently from person to person. […] Optic neuritis is the most common MOGAD presentation among adult patients. […] Transverse Myelitis in MOG Antibody Disease is often severe, with partial paralysis of lower limbs requiring a movement aid and bladder dysfunction requiring catheterisation at the patient’s worst point.
#1 Myelin oligodendrocyte glycoprotein antibody-associated disease â Overview of Information and Clinical Research
https://clinicaltrials.eu/disease/myelin-oligodendrocyte-glycoprotein-antibody-associated-disease/
Monitoring the response to treatment is crucial in managing MOGAD. Common methods include MRI scans, optical coherence tomography, and measuring MOG antibody titres. […] In cases where MOGAD leads to complications affecting vision and physical movement, rehabilitation programs may be recommended. These programs aim to help patients regain independence in their daily activities and improve their quality of life. […] Overall, while there is no cure for MOGAD, effective treatment strategies are available to manage symptoms and prevent relapses. Ongoing research and clinical trials are essential to further improve treatment outcomes and develop consensus-based guidelines. […] The prognosis for individuals with MOGAD is generally favorable. Most patients experience a milder disease course compared to NMOSD, with less severe disability.
#1 Myelin oligodendrocyte glycoprotein antibody disorders (MOGAD) – MS Australia
https://www.msaustralia.org.au/nmosd-and-mogad/myelin-oligodendrocyte-glycoprotein-antibody-disorders/
People with MOGAD often have a good response to corticosteroids but may tend to relapse on rapid corticosteroid weaning or cessation. […] About half of people with MOGAD experience a monophasic course and do not have a further relapse requiring treatment after this. […] The most common MOGAD presentation in children is acute disseminated encephalomyelitis (ADEM), which may often be preceded by a systemic infection such as a respiratory infection or a gastrointestinal illness. […] Commonly, people with MOGAD are looked after by neurologists who usually also specialise in MS and NMOSD, as MOGAD also falls under the category of demyelination. […] There remains much to learn about MOGAD, which was first identified as being an important cause of paediatric demyelination in 2007, and adult demyelination in 2014.
#1 MOG Antibody Disease (MOGAD) | Boston Children’s Hospital
https://www.childrenshospital.org/conditions/mog-antibody-disease
Myelin oligodendrocyte glycoprotein (MOG) antibody disease is a relatively rare autoimmune condition. It occurs when the immune system attacks myelin, the protective sheath that covers nerves. MOG antibody disease causes inflammation and can potentially damage the brain, spinal cord, and the optic nerves that connect the eyes to the brain. […] Treatment for MOG antibody disease is aimed at stopping symptoms, speeding recovery, and preventing future relapses. Depending on your child’s individual case, treatment options may include: […] At Boston Children’s Hospital, we care for children with MOG antibody disease in our Neuroimmunology Center. Our team of pediatric neuroimmunologists takes a multidisciplinary approach, working with other specialists throughout Boston Children’s who have expertise in caring for children with MOG antibody disease, including immunologists, infectious disease experts, ophthalmologists, psychologists, physical therapists, education specialists, and others. Together, we will create a treatment plan that puts your family in the center and aims to get your child back to optimal function and health as soon as possible.
#1 Myelin Oligodendrocyte Glycoprotein Antibody Disease | Children’s Hospital of Philadelphia
https://www.chop.edu/conditions-diseases/myelin-oligodendrocyte-glycoprotein-antibody-disease
Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a neurological, immune-mediated demyelinating disorder of the central nervous system that causes inflammation and potential damage in the optic nerve, spinal cord, brain and/or brainstem. […] At the Neuroscience Center, our goal is to stop symptoms and restore a child’s normal growth and development with as few treatment-related side effects as possible. […] Treatments of MOGAD may include: Intravenous corticosteroids, Plasma exchange (PLEX), Intravenous immunoglobulin (IVIG), Disease modifying therapies (DMTs) including therapies for children with relapsing forms of MOGAD. […] Most patients respond well to intravenous steroids, with some also requiring oral prednisone for one to four weeks. Complete recovery from the onset attack is common in children, and in general the outcome is favorable. However, patients who experience more severe attacks and relapsing MOGAD are at risk for more severe deficits. […] In children with relapsing disease, studies suggest use of intravenous immunoglobulin (IVIG) and/or disease modifying therapies (DMTs). Relapses can have long-term effects on the central nervous system, including gait and vision challenges.
#1 Pediatric Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) – EyeWiki
https://eyewiki.org/Pediatric_Myelin_Oligodendrocyte_Glycoprotein_Antibody-Associated_Disease_(MOGAD)
However, the MOGAD-ON disease course in children is milder compared with the course in adults, and children are more likely to experience complete recovery. […] The treatment of pediatric MOGAD in the acute setting is similar to that of adults although some specific considerations apply in children. […] A recent systemic review suggested that IVMP is the most commonly used acute treatment (88%) of cases and IVIG the next most common (66%). […] Most children are steroid responsive with a rapid improvement in visual acuity but a subset of patients do not respond to IVMP. […] In a retrospective review of 75 children with MOGAD, early initiation of immunotherapy (less than 7 days from symptom onset) was associated with a 6.7-fold reduced risk of relapse. […] Pediatric patients have good recovery, with studies suggesting less long-term disability compared with adults.
#1 Pediatric Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) – EyeWiki
https://eyewiki.org/Pediatric_Myelin_Oligodendrocyte_Glycoprotein_Antibody-Associated_Disease_(MOGAD)
In pediatric patients, between 75% and 96% were reported to have a complete recovery. […] Pediatric MOG-ON have also been shown to have better recovery compared with adults even when they share similar OCT findings with respect to neuroaxonal loss. […] Particularly in young patients with MOGAD, there is a predominance of monophasic disease and a good response to initial treatment. […] Long-term risk of relapse is around 35% but relapse rates in children are lower than that in adults. […] Pediatric MOGAD demonstrates several unique features compared with adult-forms of the diseases.
#1 Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) | UM Health-Sparrow
https://www.uofmhealthsparrow.org/departments-conditions/conditions/myelin-oligodendrocyte-glycoprotein-antibody-associated-disease-mogad
Myelin oligodendrocyte glycoprotein antibody-associated disease, also known as MOGAD, is a rare inflammatory disease that affects the central nervous system. In MOGAD, the immune system attacks the fatty substance that protects nerve fibers in the optic nerves, brain and spinal cord. […] There’s no cure for MOGAD. However, there are treatments to help speed the recovery from attacks, manage symptoms and reduce the likelihood of symptoms returning. […] MOGAD is often misdiagnosed as another disease that attacks myelin and causes similar symptoms. It may be mistaken for multiple sclerosis, known as MS. Or it may be confused with a condition called neuromyelitis optica spectrum disorder, also known as NMOSD. […] MOGAD is different from MS and NMOSD because the first attack of MOGAD is usually the most severe, but people with the disease can have a complete recovery. MOGAD also is diagnosed differently, using results from MRI and blood tests.
#1 MOG Antibody Disease (MOGAD) | Prognosis & Management | SRNA
https://wearesrna.org/living-with-myelitis/disease-information/mog-antibody-disease/prognosis-management/
Rituximab treatment has been associated with reduced annualized relapse rates in MOGAD. […] Studies have shown that conventional treatments for MS are not effective and may cause adverse reactions in AQP4-positive NMOSD. […] Since there is not enough information about their use in MOG antibody disease, and because they may not reduce relapse rates, or they may lead to adverse effects, treatments for MS are not recommended in MOG antibody disease.
#1 Advancing Expertise in the Understanding of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Masterclass Event Summary – European Medical Journal
https://www.emjreviews.com/neurology/symposium/advancing-expertise-in-the-understanding-of-myelin-oligodendrocyte-glycoprotein-antibody-associated-disease-masterclass-event-summary-s110224/
There is currently no approved treatment for MOGAD. The speakers explained that management has three main aims: resolving acute attacks, preventing early rebound attacks, and the long-term management of disease. […] MOGAD affects females of childbearing age, meaning patients may require acute or long-term interventions prior to, during, or post-pregnancy. […] In conclusion, the masterclass speakers explained that the clinical characteristics of demyelinating conditions, such as MOGAD, MS, and NMOSD can overlap, and that correct diagnosis is key to guiding the effective treatment of disease.
#1 Clinical Trial – Myelin Oligodendrocyte Glycoprotein Anti…
https://forpatients.roche.com/en/trials/autoimmune-disorder/mog-antibody-disease/a-study-to-evaluate-the-efficacy–safety–pharmacokinet-94806.html
The main objective of the study is to evaluate the efficacy of satralizumab compared with placebo based on time from randomization to the first occurrence of an adjudicated MOGAD relapse in the double-blind (DB) treatment period […] Meteoroid is a clinical trial designed to help people with a condition called myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). In MOGAD, the immune system mistakenly attacks a protective covering around nerve fibres, making it hard for the brain to communicate with the rest of the body. […] There is no approved, standard treatment for MOGAD. […] This clinical trial aims to compare the effects, good or bad, of satralizumab with placebo a drug that contains no active ingredients, alone or in combination with background therapy in people with MOGAD.
#1 Building the Archetype for MOGAD Care: Introducing Mayoâs New Clinic
https://www.neurologylive.com/view/building-archetype-for-mogad-care-introducing-mayo-new-clinic
Mayo’s MOGAD Clinic represents a new type of novel, multidisciplinary care, incorporating multiple different backgrounds of neurology, neuroimmunology, neuroophthalmology, and urology, among others. […] Earlier this year, Mayo Clinic launched its MOGAD Clinic, a first-of-its-kind specialty clinic devoted toward the care of patients with this rare disease. […] MOGAD requires high-quality multidisciplinary care because of the ongoing complications patients face in addition to the risk of relapse. […] Patients with the disease can face a number of common bladder problems, including incontinence, frequency, nocturia, hesitancy, and retention. […] The clinic also has a physical rehabilitation department where patients can undergo both cognitive rehab and physical rehab to help with residual symptoms in the arms or legs.
#1 International Panel of Experts Proposes New Diagnostic Criteria for MOG Antibody Associated Disease
https://www.neurologylive.com/view/international-panel-experts-proposes-new-diagnostic-criteria-mog-antibody-associated-disease
The proposed criteria for myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) includes the presence of MOG-IgG as a core criterion. […] The proposed criteria may have the potential to improve identification of individuals with MOGAD, thus improving the definition of long-term clinical outcomes, refining inclusion criteria for clinical trials, and identifying predictors of a relapsing vs monophasic disease course. […] Amongst clinical features for patients with MOG-IgG, optic neuritis is the most common onset feature, particularly among adults, along with transverse myelitis, and other less common presentations. […] „Tools that quantify visual impairment would be valuable in MOGAD, given the predilection for the optic nerve,” Banwell et al wrote. […] The investigators noted that serum is the preferred specimen type for MOG-IgG testing, as well as strongly endorsed serum testing using cell-based assays that use full-length human MOG.
#1 The MOG Project | MOG Antibody Disease Awareness, Research & Education
https://mogproject.org/
We have a full suite of really helpful educational materials of all media types for patients, caregivers and medical professionals backed by leading experts in MOGAD […] MOG is a protein located on the surface of myelin sheaths in the central nervous system. […] MOGAD is diagnosed through a test that looks for the level of MOG antibodies in the blood. The test should be given to any patient who has an inflammatory attack of the central nervous system. […] The MOG Project is devoted to raising awareness, educating doctors, patients and caregivers, advancing research through expert collaboration and fundraising, and providing support and advocacy for our community in hopes of finding a cure. […] We are the preeminent 501(c)3 organization solely devoted to globally advocating for patients of Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD). […] Through grants from The MOG Project, we are proud to have been a major contributor to collaborative meetings where researchers and clinicians gather to discuss their latest research on MOGAD.
#2 Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management
https://pmc.ncbi.nlm.nih.gov/articles/PMC7795410/
Myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD) is a rare, antibody-mediated inflammatory demyelinating disorder of the central nervous system (CNS) with various phenotypes starting from optic neuritis, via transverse myelitis to acute demyelinating encephalomyelitis (ADEM) and cortical encephalitis. […] A critical element of reliable diagnosis is detection of pathogenic serum antibodies MOG with accurate, specific and sensitive methods, preferably with optimized cell-based assay (CBA). […] Reports on randomised control trials are limited, but observational open-label experience suggests a role for high-dose steroids and plasma exchange in the treatment of acute attacks, and for immunosuppressive therapies, such as steroids, oral immunosuppressants and rituximab as maintenance treatment.
#2 Myelin Oligodendrocyte Glycoprotein-Antibody Associated Disease: An Updated Review of the Clinical Spectrum, Pathogenetic Mechanisms and Therapeutic Management
https://www.mdpi.com/2073-4468/13/2/43
Randomized clinical trials, standardized diagnostic criteria and treatment guidelines are the steps forward. […] MOGAD can occur at any age; however, the incidence is higher in children compared to adults when compared to MS and AQP4 + NMOSD, with MOGAD being a more frequent cause of a first demyelinating episode in children than in adults. […] MOGAD associated syndromes are summarized in Table 1. […] Patients with severe symptoms can improve dramatically only after a short course of intravenous steroids. […] It is recommended that a 3â5-day course of 1g of intravenous methylprednisolone should be given depending on the severity and the response of the attack. […] In severe cases, or in those who will not improve after 5 days, escalation to plasma exchange (5â7 cycles on alternative days), intravenous immunoglobulins (total of 2 g/kg over 2 or 5 days), or plasma exchange followed by intravenous immunoglobulins can be considered.
#2 Myelin oligodendrocyte glycoprotein antibody disorders (MOGAD) – MS Australia
https://www.msaustralia.org.au/nmosd-and-mogad/myelin-oligodendrocyte-glycoprotein-antibody-disorders/
People with MOGAD often have a good response to corticosteroids but may tend to relapse on rapid corticosteroid weaning or cessation. […] About half of people with MOGAD experience a monophasic course and do not have a further relapse requiring treatment after this. […] The most common MOGAD presentation in children is acute disseminated encephalomyelitis (ADEM), which may often be preceded by a systemic infection such as a respiratory infection or a gastrointestinal illness. […] Commonly, people with MOGAD are looked after by neurologists who usually also specialise in MS and NMOSD, as MOGAD also falls under the category of demyelination. […] There remains much to learn about MOGAD, which was first identified as being an important cause of paediatric demyelination in 2007, and adult demyelination in 2014.
#2 Myelin Oligodendrocyte Glycoprotein Antibody Disease
https://www.cincinnatichildrens.org/health/m/mogad
Some children with MOGAD stay on medication to prevent further relapses. Doctors will watch closely for new symptoms. Repeated brain MRIs may also be recommended. […] Some children may only have one MOG attack and recover well with acute therapy. Some may have residual symptoms after an attack. The risk of having another MOG attack after a first event is around 40-50%. With treatment and prevention of relapses, most children do not develop significant disability from MOGAD. […] Managing flare-ups is important to maintain the best possible health, function and movement. Typically, children who have MOGAD have a good recovery and flare-ups are generally rare but can occur. Sometimes flare-ups may cause lasting damage to nerves. A child may not get back certain movements or functions. Alerting your doctor to any concerns around flare-ups or new symptoms is important to help ensure the right treatment is started, if needed.
#2 MOG Antibody Disease Information – MyMyelitis
https://mymyelitis.com/mog-antibody-disease/information/
Depending on how badly the disabilities and symptoms affect a person, some lifestyle complications may arise. […] Those with optic neuritis may experience residual vision loss due to the MOGAD attack. […] Spasticity is the stiffness or spasms in our muscles often caused by a spinal cord attack. […] Neuropathic pain can be described in many ways, including burning, stabbing, tingling, or constricting. […] Another complication of spinal cord inflammation caused by MOG Antibody Disease is bladder and bowel issues. […] Fatigue is when you lack physical or mental energy and can be an issue when dealing with/recovering from MOG Antibody Disease. […] Many people find that being diagnosed with MOG Antibody Disease has a damaging effect on their and their family’s mental health.
#2 MOG Antibody-Associated Disease | Henry Ford Health – Detroit, MI
https://www.henryford.com/services/neuroinflammatory-disorders-and-ms/neuroinflammatory-diseases-we-treat/mog-antibody-associated-disease
Care may also include immunosuppressants, drugs that quiet immune system activity. These drugs lower the likelihood of future attacks. […] You may benefit from seeing additional specialists who help prevent and manage complications, including: Neuro-ophthalmologists care for optic nerve concerns, Pain medicine doctors perform procedures that reduce stubborn pain, Neurorehabilitation therapists and physiatrists (physical medicine and rehabilitation doctors) deliver services that relieve spasticity and optimize your abilities, Vision rehabilitation specialists help you cope with low vision and vision loss. […] After your first MOG antibody attack, it can be challenging to determine whether you have monophasic or relapsing disease. This is why monitoring is essential. You undergo periodic MRIs, blood testing and exams. […] Our team nurse helps you access the services and support you need.
#2 Neuromyelitis Optica & MOG Antibody Disorder Treatment & Research Program | NYU Langone Health
https://nyulangone.org/care-services/multiple-sclerosis-comprehensive-care-center/neuromyelitis-optica-mog-antibody-disorder-treatment-research-program
Myelin oligodendrocyte glycoprotein antibody associated disorder (MOGAD) is a recently described autoimmune disease that may resemble NMOSD, but requires a different treatment. […] Care for people with NMOSD and MOGAD is provided by our dedicated team, which includes neurologists, neuro-ophthalmologists, a neuro-urologist, nurse coordinators, social workers, occupational therapists, and psychologists. […] For MOGAD relapse prevention, there are no FDA-approved treatments. Several medications are used off label, including intravenous immunoglobulins, subcutaneous immunoglobulins, and oral immunosuppressant drugs such as mycophenolate mofetil (CellCept). Our center is currently participating in a clinical trial, which, if successful, could lead to approval of the first drug for MOGAD. […] People with NMOSD and MOGAD may experience symptoms caused by damage to the nervous tissue. A variety of medications, as well as non-medication approaches, are available to alleviate common symptoms of these diseases.
#2 Building the Archetype for MOGAD Care: Introducing Mayoâs New Clinic
https://www.neurologylive.com/view/building-archetype-for-mogad-care-introducing-mayo-new-clinic
Mayo’s MOGAD Clinic represents a new type of novel, multidisciplinary care, incorporating multiple different backgrounds of neurology, neuroimmunology, neuroophthalmology, and urology, among others. […] Earlier this year, Mayo Clinic launched its MOGAD Clinic, a first-of-its-kind specialty clinic devoted toward the care of patients with this rare disease. […] MOGAD requires high-quality multidisciplinary care because of the ongoing complications patients face in addition to the risk of relapse. […] Patients with the disease can face a number of common bladder problems, including incontinence, frequency, nocturia, hesitancy, and retention. […] The clinic also has a physical rehabilitation department where patients can undergo both cognitive rehab and physical rehab to help with residual symptoms in the arms or legs.
#2 Pediatric Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) – EyeWiki
https://eyewiki.org/Pediatric_Myelin_Oligodendrocyte_Glycoprotein_Antibody-Associated_Disease_(MOGAD)
Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) is a demyelinating disease of the central nervous system associated with seropositivity of the MOG antibody. Pediatric MOG has a wide clinical phenotype and MOG antibody testing should be considered in all children with CNS demyelinating disease. […] The diagnosis of MOGAD is important for counseling patients and their families on relapse risk and available treatments. […] Pediatric MOGAD is more heterogenous than the adult form of the disease, with the differing features of pediatric disease accentuated in younger patients. […] The most common presentation of MOGAD in children is acute disseminated encephalomyelitis (ADEM), which makes up around 40%-50% of all presenting cases of pediatric MOGAD. […] Interestingly this difference in presenting features also applies to reoccurrences. Younger patients who had ADEM as a first ADS are more likely to get reoccurrences presenting as ON as they get older.
#2 Emerging Principles for Treating Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) | CoLab
https://colab.ws/articles/10.1007%2Fs11940-023-00776-1
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare inflammatory disorder of the central nervous system that affects both adults and children. Neurologic disability is relapse-driven; therefore, early diagnosis and targeted treatment are critical for effective care. We review the new MOGAD diagnostic criteria and evidence for current acute and preventative therapies. The International MOGAD Panel has released the first clinical, laboratory, and radiographic criteria for MOGAD diagnosis. These criteria set the stage for evaluating clinical investigations and designing future randomized clinical trials. Prior retrospective studies have evaluated multiple off-label agents for the acute care or prevention of MOGAD attacks, and prospective randomized clinical trials are now underway. Acute MOGAD attacks are generally responsive to high-dose corticosteroids; however, early use of plasma exchange or intravenous immunoglobulin may be beneficial for severe attacks or cases lacking corticosteroid response. A slow corticosteroid taper may lower the risk of relapse. Preventative treatment has been typically limited to patients with a definitive relapsing disease. While there is no consensus on the choice or duration of treatment, multiple therapies have been retrospectively evaluated. Prospective placebo-controlled trials for interleukin-6 receptor inhibition and neonatal Fc receptor inhibition may open new frontiers for patient care.
#2 Building the Archetype for MOGAD Care: Introducing Mayoâs New Clinic
https://www.neurologylive.com/view/building-archetype-for-mogad-care-introducing-mayo-new-clinic
The ability to bring in all different specialties allows those in the clinic to confirm and validate diagnoses and ultimately start patients on the right treatment path for long-term success. […] These multidisciplinary clinics are so important for patients with MOGAD. The disease is new so I think this is the first ever designated MOGAD clinic and many other centers will follow along.