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Item Type: | Review |
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Title: | 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. |
Keywords: | Myelin Oligodendrocyte Glycoprotein (MOG) Antibodies, Consensus Recommendations, Diagnosis, Antibody Testing, Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), Optic Neuritis (ON), Myelitis, Animals |
Source: | Journal of Neuroinflammation |
ISSN: | 1742-2094 |
Publisher: | BioMed Central |
Volume: | 15 |
Number: | 1 |
Page Range: | 134 |
Date: | 3 May 2018 |
Official Publication: | https://doi.org/10.1186/s12974-018-1144-2 |
PubMed: | View item in PubMed |
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