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...

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Bibliographic Details
Published in:Journal of neuroinflammation Vol. 15; no. 1; pp. 134 - 10
Main Authors: 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., Wildemann, B.
Format: Journal Article
Language:English
Published: London BioMed Central 03.05.2018
BioMed Central Ltd
BMC
Subjects:
Animals
Antibody testing
Autoantibodies - blood
Biomarkers - blood
Biomedical and Life Sciences
Biomedicine
Central nervous system diseases
Consensus recommendations
Diagnosis
Diagnòstic
Encephalomyelitis
Encephalomyelitis - blood
Encephalomyelitis - diagnosis
Esclerosi múltiple
Genetic aspects
Glycoproteins
Humans
Immune system
Immunoenzyme Techniques - methods
Immunoenzyme Techniques - trends
Immunoglobulin G - blood
Immunology
Internationality
Malalties del sistema nerviós central
Mielitis
Multiple sclerosis
Multiple sclerosis (MS)
Myelin oligodendrocyte glycoprotein (MOG) antibodies
Myelin-Oligodendrocyte Glycoprotein - blood
Myelitis
Neurobiology
Neurology
Neuromyelitis optica spectrum disorders (NMOSD)
Neurosciences
Review
Testing
Myelin oligodendrocyte glycoprotein (MOG) antibodies
Multiple sclerosis (MS)
Antibody testing
Diagnosis
Neuromyelitis optica spectrum disorders (NMOSD)
Optic neuritis (ON), Myelitis
Consensus recommendations
ISSN:1742-2094, 1742-2094
Online Access:Get full text
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Description
Summary: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.
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ISSN:1742-2094
1742-2094
DOI:10.1186/s12974-018-1144-2