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Neuropediatrics 2025; 56(04): 226-233
DOI: 10.1055/a-2579-6247
Original Article

MOG-Encephalitis is the Most Prevalent Autoimmune Encephalitis in Children: MERIN Study Data on Encephalitis

Ruth Helena Fellmeth
1   Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
,
Lampros Kousoulos
1   Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
,
George Christoph Korenke
2   Department of Neuropediatrics, University Children's Hospital, Klinikum Oldenburg, Oldenburg, Germany
,
Hans-Jürgen Christen
3   Department of Pediatrics, Children's Hospital auf der Bult, Hannover, Germany
,
Masyar Monazahian
4   Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
,
Justine Dargvainiene
5   Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany
,
Klaus-Peter Wandinger
5   Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany
6   Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany
,
Frank Leypoldt
5   Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany
7   Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
,
Kevin Rostásy
1   Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany
› Author Affiliations
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).
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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.

Keywords

autoimmune encephalitis - myelin-oligodendrocyte glycoprotein - antibodies - children

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

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