{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T18:38:03Z","timestamp":1782758283606,"version":"3.54.5"},"reference-count":26,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Purpose: Optic neuritis (ON) is a rare disease that may remain a single episode or transform into MS. OCBs and spinal MRI lesions have already been identified as prognostic factors. Aim: Our aim was to evaluate if the presence of more than one elevated antibody index of measles, rubella, and\/or varicella-zoster (MRZ) is an indicator of risk of conversion. Methods: In total, 228 patients diagnosed with ON between 1990 and 2013 were included in this retrospective study. All children had a data set consisting of age, sex, ON type, MRI, and detailed CSF studies, including the presence of OCBs and MRZ reactions and a follow-up of at least 1.5 years. Children were then divided into two groups: those who developed MS according to the McDonald criteria 2010 (n = 92) and those who did not (n = 136). Binary logistic regression analysis was used to assess the relationship between the different prognostic factors and conversion to MS. Positive (PPV) and negative predictive values were calculated. Results: Binary logistic regression analysis revealed that an MS-like MRI (p &lt; 0.001), positive OCBs (p = 0.002), and a positive MRZ reaction (p &lt; 0.001) were significant prognostic factors for conversion to MS after ON. Calculated PPVs showed a positive MRZ reaction alone to already be a good predictor (PPV 0.90 (95%CI: 0.82 to 0.95), p &lt; 0.001). The best prediction was possible with a combination of cMRI, the presence of OCBs, and a positive MRZ reaction (PPV 1.00 (0.93 to 1.00), p &lt; 0.001). Conclusions: Our findings show that a positive MRZ reaction alone already has a high predictive value for future conversion to MS and should be included in the workup of a child with an initial demyelinating event.<\/jats:p>","DOI":"10.3390\/children12040497","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T07:42:01Z","timestamp":1744616521000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Presence of MRZ Reactions Improves the Prediction of Multiple Sclerosis in Children with Optic Neuritis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8307-5829","authenticated-orcid":false,"given":"Franziska","family":"Kauth","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology, Children\u2019s Hospital Datteln, University Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Children\u2019s Hospital Datteln, University Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva-Maria","family":"Wendel","sequence":"additional","affiliation":[{"name":"Olgahospital Stuttgart, Kinderneurologie, D-70174 Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2817-1402","authenticated-orcid":false,"given":"Markus","family":"Reindl","sequence":"additional","affiliation":[{"name":"Clinical Department of Neurology Innsbruck, Medical University of Innsbruck, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Heu\u00dfinger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nuremberg General Hospital, Paracelsus Medical University, D-90471 Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2180-5321","authenticated-orcid":false,"given":"Kevin","family":"Rost\u00e1sy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Children\u2019s Hospital Datteln, University Witten\/Herdecke, D-45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/S1474-4422(22)00431-8","article-title":"Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria","volume":"22","author":"Banwell","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1002\/ana.24409","article-title":"Oligoclonal bands predict multiple sclerosis in children with optic neuritis","volume":"77","author":"Heussinger","year":"2015","journal-title":"Ann. 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