Objective:To characterize disease severity and distribution of disability in pediatric-onset multiple sclerosis (POMS) and to develop an optimized modeling scale for measuring disability we performed a multi-center retrospective analysis of disability scores in 873 persons with POMS over time and compared this to previously published data in adults with multiple sclerosis (MS).Methods:Retrospective analysis of prospectively collected data collected from twelve centers of the U.S. Network of Pediatric MS Centers. Patients were stratified by the number of years from first symptoms of MS to EDSS assessment and an MS severity score (Ped-MSSS) was calculated per criteria developed by Roxburgh et al in 2005.Results:In total, 873 patients were evaluated. In our cohort, 52%, 19.4%, and 1.5% of all patients at any time point reached an EDSS of 2.0, 3.0 and 6.0. Comparison of our Ped-MSSS scores and previously published adult MSSS scores showed slower progression of Ped-MSSS with increasing gaps between higher EDSS score and years after diagnosis. Decile scores in our POMS cohort for EDSS of 2.0, 3.0, and 6.0 were 8.00/9.46/9.94 7.86/9.39/9.91 and 7.32/9.01/9.86 at 2, 5 and 10 years respectively. Notable predictors of disease progression in both EDSS and Ped-MSSS models were “ever having a motor relapse”, and EDSS at year 1. Symbol Digit Modalities Test (SDMT) scores were inversely correlated with duration of disease activity and cerebral functional score.Conclusions:Persons with POMS exhibit lower EDSS scores compared to persons with adult-onset MS. Use of a Ped-MSSS model may provide an alternative to EDSS scoring in clinical assessment of disease severity and disability accrual.

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Myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) is a recently described CNS inflammatory disorder that may manifest with optic neuritis, myelitis, seizures, and/or acute disseminated encephalomyelitis. While MOG-specific antibodies in patients with MOGAD are IgG1, a T-cell–dependent antibody isotype, immunologic mechanisms of this disease are not fully understood. Thymic hyperplasia can be associated with certain autoimmune diseases. In this report we describe a case of MOGAD associated with thymic hyperplasia in a young adult.