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| Item Type: | Review |
|---|---|
| Title: | MOG-Enzephalomyelitis: Internationale Empfehlungen zu Diagnose und Antikörpertestung [MOG encephalomyelitis: international recommendations on diagnosis and antibody testing] |
| Creators Name: | Jarius, S., Paul, F., Aktas, O., Asgari, N., Dale, R.C., de Seze, J., Franciotta, D., Fujihara, K., Jacob, A., Kim, H.J., Kleiter, I., Kümpfel, T., Levy, M., Palace, J., Ruprecht, K., Saiz, A., Trebst, C., Weinshenker, B.G. and Wildemann, B. |
| Abstract: | Over the past few years, new-generation cell-based assays have demonstrated a robust association of autoantibodies to full-length human myelin oligodendrocyte glycoprotein (MOG-IgG) with (mostly recurrent) optic neuritis, myelitis and brainstem encephalitis, 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 classic multiple 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 established MS 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. |
| Keywords: | Myelin Oligodendrocyte Glycoprotein (MOG) Antibodies, Consensus Recommendations, Diagnosis, Antibody Testing, Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), Optic Neuritis (ON), Myelitis |
| Source: | Nervenarzt |
| ISSN: | 0028-2804 |
| Publisher: | Springer |
| Volume: | 89 |
| Number: | 12 |
| Page Range: | 1388-1399 |
| Date: | December 2018 |
| Official Publication: | https://doi.org/10.1007/s00115-018-0607-0 |
| PubMed: | View item in PubMed |
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