Diagnostic features of initial demyelinating events associated with serum MOG-IgG.

Abstract

BACKGROUND:

Myelin oligodendrocyte glycoprotein (MOG)-IgG associated disorders are increasingly recognized as a distinct disease entity. However, diagnostic sensitivity and specificity of serum MOG-IgG as well as recommendations for testing are still debated.

MATERIALS AND METHODS:

Between October 2015 and July 2017 we tested serum MOG-IgG in 91 adult patients (49 females) with a demyelinating event (DE) not fulfilling 2010 McDonald criteria for MS at sampling, negative for neuromyelitis optica (NMO)-IgG and followed-up for at least 12 months. We assessed the sensitivity and specificity of a live-cell MOG-IgG assay for each final diagnosis at last follow-up, for the 2018 international recommendations for MOG-IgG testing, and for other combinations of clinical and laboratory characteristics.

RESULTS:

Clinical presentations included acute myelitis (n = 48), optic neuritis (n = 36), multifocal encephalomyelitis (n = 4), and brainstem syndrome (n = 3). Twenty-four patients were MOG-IgG positive. Sensitivity and specificity of MOG-IgG test applied to the 2018 international recommendations were 28.4% and 86.7%, while they were 42.1% and 88.6% when applied to DE of unclear aetiology as defined above with two or more among: 1_no periventricular and juxtacortical MS-like lesions on brain MRI; 2_longitudinally extensive MRI optic nerve lesion; 3_no CSF-restricted oligoclonal bands; 4_CSF protein > 50 mg/dl.

CONCLUSIONS:

Simplified requirements compared to those currently proposed for MOG-IgG testing could facilitate the applicability of the assay in the diagnosis of adults with DEs of unclear aetiology.

• Authors: Riccardo Orlandi, Sara Mariotto, Sergio Ferrari, Francesca Gobbin, Elia Sechi, Ruggero Capra, Chiara Rosa Mancinelli, Roberto Bombardi, Luigi Zuliani, Marco Zoccarato, Francesca Rossi, Valentina Camera, Diana Ferraro, Maria Donata Benedetti, Markus Reindl, Alberto Gajofatto
• Journal: Journal of neuroimmunology (J Neuroimmunol) Vol. 344 Pg. 577260 (07 15 2020) ISSN: 1872-8421 [Electronic] Netherlands
• PMID: 32442864 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier B.V. All rights reserved.

Chemical References

• Autoantibodies
• Immunoglobulin G
• Myelin-Oligodendrocyte Glycoprotein

Topics

• Adult
• Aged
• Autoantibodies (blood, cerebrospinal fluid)
• Cohort Studies
• Demyelinating Diseases (blood, cerebrospinal fluid, diagnostic imaging)
• Female
• Follow-Up Studies
• HEK293 Cells
• Humans
• Immunoglobulin G (blood, cerebrospinal fluid)
• Male
• Middle Aged
• Myelin-Oligodendrocyte Glycoprotein (blood, cerebrospinal fluid)
• Young Adult