Abstract
Over the past few years, new-generation cellbased assays have demonstrated a robust association of autoantibodies to full-length human myelin oligodendrocyte glycoprotein (MOG-IgG) with (mostly recurrent) optic neuritis,myelitis and brainstemencephalitis, as well as with acute disseminated encephalomyelitis (ADEM) -like presentations. Most experts now consider MOG-IgG-associated encephalomyelitis (MOG-EM) a disease entity in its own right, immunopathogenetically distinct from both classicmultiple sclerosis (MS) and aquaporin-4 (AQP4) -IgG-positive neuromyelitis optica spectrum disorders (NMOSD). Owing to a substantial overlap in clinicoradiological presentation, MOG-EM was often unwittingly misdiagnosed as MS in the past. Accordingly, increasing numbers of patients with suspected or establishedMS are currently being tested for MOG-IgG. However, screening of large unselected cohorts for rare biomarkers can significantly reduce the positive predictive value of a test. To lessen the hazard of overdiagnosing MOG-EM, which may lead to inappropriate treatment,more selective criteria for MOG-IgG testing are urgently needed. In this paper, we propose indications for MOG-IgG testing based on expert consensus. In addition, we give a list of conditions atypical for MOG-EM (“red flags”) that should prompt physicians to challenge a positive MOG-IgG test result. Finally, we provide recommendations regarding assay methodology, specimen sampling and data interpretation, and propose for the first time diagnostic criteria for MOG-EM.
Translated title of the contribution | Mog encephalomyelitis: International recommendations on diagnosis and antibody testing |
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Original language | German |
Pages (from-to) | 1388-1399 |
Number of pages | 12 |
Journal | Nervenarzt |
Volume | 89 |
Issue number | 12 |
DOIs | |
State | Published - 2018 |
Keywords
- Antibody testing
- Consensus recommendations
- Diagnosis
- Multiple sclerosis (MS)
- Myelin oligodendrocyte glycoprotein (MOG) antibodies
- Myelitis
- Neuromyelitis optica spectrum disorders (NMOSD)
- Optic neuritis (ON)
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Psychiatry and Mental health