MOG encephalomyelitis: international recommendations on diagnosis and antibody testing
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 enceph...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BioMed Central
2018
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| _version_ | 1826283662424932352 |
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| author | Jarius, S Paul, F Aktas, O Asgari, N Dale, RC De Seze, J Franciotta, D Fujihara, K Jacob, A Kim, HJ Kleiter, I Kümpfel, T Levy, M Palace, J Ruprecht, K Saiz, A Trebst, C Weinshenker, BG Wildemann, B |
| author_facet | Jarius, S Paul, F Aktas, O Asgari, N Dale, RC De Seze, J Franciotta, D Fujihara, K Jacob, A Kim, HJ Kleiter, I Kümpfel, T Levy, M Palace, J Ruprecht, K Saiz, A Trebst, C Weinshenker, BG Wildemann, B |
| author_sort | Jarius, S |
| collection | OXFORD |
| description | 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. |
| first_indexed | 2024-03-07T01:02:16Z |
| format | Journal article |
| id | oxford-uuid:8a21ba27-a318-4015-94ae-ba0ede9ad652 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:02:16Z |
| publishDate | 2018 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:8a21ba27-a318-4015-94ae-ba0ede9ad6522022-03-26T22:29:25ZMOG encephalomyelitis: international recommendations on diagnosis and antibody testingJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8a21ba27-a318-4015-94ae-ba0ede9ad652EnglishSymplectic Elements at OxfordBioMed Central2018Jarius, SPaul, FAktas, OAsgari, NDale, RCDe Seze, JFranciotta, DFujihara, KJacob, AKim, HJKleiter, IKümpfel, TLevy, MPalace, JRuprecht, KSaiz, ATrebst, CWeinshenker, BGWildemann, BOver 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. |
| spellingShingle | Jarius, S Paul, F Aktas, O Asgari, N Dale, RC De Seze, J Franciotta, D Fujihara, K Jacob, A Kim, HJ Kleiter, I Kümpfel, T Levy, M Palace, J Ruprecht, K Saiz, A Trebst, C Weinshenker, BG Wildemann, B MOG encephalomyelitis: international recommendations on diagnosis and antibody testing |
| title | MOG encephalomyelitis: international recommendations on diagnosis and antibody testing |
| title_full | MOG encephalomyelitis: international recommendations on diagnosis and antibody testing |
| title_fullStr | MOG encephalomyelitis: international recommendations on diagnosis and antibody testing |
| title_full_unstemmed | MOG encephalomyelitis: international recommendations on diagnosis and antibody testing |
| title_short | MOG encephalomyelitis: international recommendations on diagnosis and antibody testing |
| title_sort | mog encephalomyelitis international recommendations on diagnosis and antibody testing |
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