Value of Area Postrema Syndrome in Differentiating Adults With AQP4 vs. MOG Antibodies

Jae-Won Hyun; Young Nam Kwon; Sung-Min Kim; Hye Lim Lee; Woo Kyo Jeong; Hye Jung Lee; Byoung Joon Kim; Seung Woo Kim; Ha Young Shin; Hyun-June Shin; Sun-Young Oh; So-Young Huh; Woojun Kim; Min Su Park; Jeeyoung Oh; Hyunmin Jang; Na Young Park; Min Young Lee; Su-Hyun Kim; Ho Jin Kim

doi:10.3389/fneur.2020.00396

Value of Area Postrema Syndrome in Differentiating Adults With AQP4 vs. MOG Antibodies

Front Neurol. 2020 Jun 4:11:396. doi: 10.3389/fneur.2020.00396. eCollection 2020.

Authors

Jae-Won Hyun¹, Young Nam Kwon^{2

3}, Sung-Min Kim², Hye Lim Lee⁴, Woo Kyo Jeong^{5

6}, Hye Jung Lee^{5

6}, Byoung Joon Kim^{5

6}, Seung Woo Kim⁷, Ha Young Shin⁷, Hyun-June Shin⁸, Sun-Young Oh⁸, So-Young Huh⁹, Woojun Kim¹⁰, Min Su Park¹¹, Jeeyoung Oh¹², Hyunmin Jang¹, Na Young Park¹, Min Young Lee¹, Su-Hyun Kim¹, Ho Jin Kim¹

Affiliations

¹ Department of Neurology, National Cancer Center, Goyang, South Korea.
² Department of Neurology, Seoul National University Hospital, Seoul, South Korea.
³ The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Seoul, South Korea.
⁴ Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
⁵ Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁶ Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, South Korea.
⁷ Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
⁸ Department of Neurology, School of Medicine, Chonbuk National University, Jeonju, South Korea.
⁹ Department of Neurology, Kosin University College of Medicine, Busan, South Korea.
¹⁰ Department of Neurology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.
¹¹ Department of Neurology, Yeungnam University College of Medicine, Daegu, South Korea.
¹² Department of Neurology, Konkuk University School of Medicine, Seoul, South Korea.

Abstract

Objectives: To compare the frequency of area postrema syndrome (APS) in adults with anti-aquaporin-4 (AQP4) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies. Methods: APS is defined as acute or subacute, single or combined, episodic or constant nausea, vomiting, or hiccups, persisting for at least 48 h, which cannot be attributed to any other etiology. The presence of APS was investigated in 274 adults with AQP4 antibodies and 107 adults with MOG antibodies from 10 hospitals. Results: The study population comprised Korean adults (≥18 years). At the time of disease onset, 14.9% (41/274) adults with AQP4 antibodies had APS, while none of the participants with MOG antibodies developed APS (p < 0.001). During the course of the disease, 17.2% (47/274) adults with AQP4 antibodies had APS in contrast to 1.9% (2/107) adults with MOG antibodies with APS (p < 0.001). Conclusions: APS, one of the core clinical characteristics of individuals with AQP4 antibodies, is an extremely rare manifestation in Korean adults with MOG antibodies.

Keywords: MOG antibody; aquaporin-4 antibody; area postrema syndrome; diagnosis; neuromyelitis optica spectrum disorder.