This study aimed to determine the seropositivity of myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) and aquaporin-4 antibodies (AQP4-Ab) and outcomes in children with acquired demyelinating syndromes (ADSs). Children (6 months–15 years) with suspected ADS were enrolled and tested for MOG-Ab and AQP4-Ab prospectively over 18 months at a tertiary care hospital in North India. Children with proven nonimmune-mediated neurological disorders were enrolled as controls. Of 79 children with suspected ADS, 66 were enrolled. Among the enrolled children with ADS, acute demyelinating encephalomyelitis (ADEM) (25) was the most common first clinical event followed by optic neuritis (ON) (20) and transverse myelitis (TM) (19; one child had ON and TM simultaneously [neuromyelitis optica spectrum disorders [NMOSDs]]), while two children had clinically isolated syndrome (CIS) apart from ON and TM. Fourteen (21.2%, confidence interval [CI] 11.3–31.1) tested positive for one antibody (12 [18.1%; 95% CI 10.5–25.5%] for MOG-Ab and 2 [3%; 95% CI 0–7.2%] for AQP4-Ab). None of the 62 controls tested positive for any antibody. The final diagnosis in those with the monophasic ADS was ADEM (21), ON (13), TM (16), and other CIS (1) while that in children with recurrent events was multiphasic disseminated encephalomyelitis (MDEM) (2), NMOSD (3), ADEM-ON (4), recurrent ON (4), and MS (2). Among those with the first event, 4/51 (7.8%; 95% CI 0.5–15.2%) were MOG-Ab positive and 2 AQP4-Ab positive, whereas 8/15 (53.3% [95% CI 28.1–78.6%]) with recurrent events (MDEM [2], ADEM-ON [4], recurrent ON [1], and recurrent TM [1]) were MOG-Ab positive. Hence, MOG-Abs are the most common antibodies detected in one in five children with pediatric ADS, especially in relapsing disease. AQP4-Abs are rare in children with ADS.

本研究旨在确定髓鞘少突胶质细胞糖蛋白抗体 (MOG-Ab) 和水通道蛋白-4 抗体 (AQP4-Ab) 的血清阳性以及获得性脱髓鞘综合征 (ADS) 儿童的预后。在印度北部的一家三级护理医院，对疑似 ADS 的儿童（6 个月至 15 岁）进行了 18 个月的前瞻性登记和 MOG-Ab 和 AQP4-Ab 检测。患有经证实的非免疫介导的神经系统疾病的儿童被选为对照。在 79 名疑似 ADS 的儿童中，有 66 名入组。在入组的 ADS 患儿中，急性脱髓鞘性脑脊髓炎 (ADEM) (25) 是最常见的首发临床事件，其次是视神经炎 (ON) (20) 和横贯性脊髓炎 (TM) (19)；一名儿童同时患有 ON 和 TM。视神经脊髓炎谱系障碍 [NMOSDs]]), 除 ON 和 TM 外，还有两名儿童患有临床孤立综合征 (CIS)。14 人（21.2%，置信区间 [CI] 11.3–31.1）对一种抗体检测呈阳性（12 [18.1%；95% CI 10.5–25.5%] MOG-Ab 和 2 [3%；95% CI 0–7.2%] ] 对于 AQP4-Ab)。62 名对照中没有人检测出任何抗体呈阳性。单相 ADS 患者的最终诊断为 ADEM (21)、ON (13)、TM (16) 和其他 CIS (1)，而复发性事件儿童的最终诊断为多相播散性脑脊髓炎 (MDEM) (2)、NMOSD (3)、ADEM-ON (4)、复发性 ON (4) 和 MS (2)。在第一次事件中，4/51 (7.8%; 95% CI 0.5–15.2%) MOG-Ab 阳性和 2 个 AQP4-Ab 阳性，而 8/15 (53.3% [95% CI 28.1–78.6%] ) 复发事件（MDEM [2]、ADEM-ON [4]、复发性 ON [1] 和复发性 TM [1]）为 MOG-Ab 阳性。因此，MOG-Abs 是在五分之一的儿科 ADS 儿童中检测到的最常见的抗体，尤其是在复发性疾病中。AQP4-Abs 在患有 ADS 的儿童中很少见。