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DOI: 10.1055/a-2579-6247
MOG-Encephalitis is the Most Prevalent Autoimmune Encephalitis in Children: MERIN Study Data on Encephalitis
Funding The preparation of this study and the research presented herein were supported in part by grants from the German Federal Ministry of Education and Research (CONNECT-GENERATE grant no. 01GM1908A and 01GM2208A).

Abstract
Introduction
Encephalitis in children is a serious inflammatory brain disease caused by infectious or autoimmune-mediated processes. The frequency of autoimmune variants in pediatric populations is not entirely clear.
Aim
To study the frequency of myelin oligodendrocyte glycoprotein (MOG) antibody (ab)-mediated autoimmune encephalitis (AE) in children included in the Meningitis/Encephalitis register of Lower Saxony (MERIN).
Methods
Medical records of 1,341 children treated between 2011 and 2020 in two large children's hospitals participating in a prospective study on encephalitis (MERIN) were reviewed. Children meeting diagnostic criteria for possible AE were finally included if serum samples and informed re-consent were available. Children with pathogen-mediated encephalitis were also included as controls. All available serum samples were tested for MOG- and anti-N-methyl-D-aspartate receptor (NMDAR) antibodies (abs) using cell- and tissue-based assay (TBA).
Results
We included 55 children of whom 16 had pathogen-associated meningoencephalitis. Thirty-nine out of fifty-five children were classified as possible AE and 3/39 fulfilled the criteria for MOG ab-associated disease (MOGAD). No patients' sera harbored NMDAR abs. However, 5/39 patients fulfilled the criteria for probable, auto-ab-negative AE.
Conclusion
In line with recent research our study suggests that ab-mediated AE and probable ab-negative AE are rare in children. The existing criteria seem suitable for identifying patients with AE but should include the testing of serum MOG abs. Further yet unknown abs may play a role in children with AE.
Authors' Contributions
K.R. designed the study. R.F. and K.R. consulted the literature, wrote the manuscript, and made the tables. K.R., R.F., L.K., H.-J.C., and G.-C.K. collected the clinical data of the patients. F.L., J.D., and K.-P.W. made antibody testing. All authors contributed to editorial changes in the manuscript, and read, and approved the final manuscript.
Publication History
Received: 28 January 2025
Accepted: 09 April 2025
Accepted Manuscript online:
10 April 2025
Article published online:
16 May 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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