Title |
MOG encephalomyelitis: international recommendations on diagnosis and antibody testing
|
---|---|
Published in |
Journal of Neuroinflammation, May 2018
|
DOI | 10.1186/s12974-018-1144-2 |
Pubmed ID | |
Authors |
S. Jarius, F. Paul, O. Aktas, N. Asgari, R. C. Dale, J. de Seze, D. Franciotta, K. Fujihara, A. Jacob, H. J. Kim, I. Kleiter, T. Kümpfel, M. Levy, J. Palace, K. Ruprecht, A. Saiz, C. Trebst, B. G. Weinshenker, B. Wildemann |
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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 7 | 32% |
United States | 3 | 14% |
Italy | 2 | 9% |
Spain | 2 | 9% |
Serbia | 1 | 5% |
Canada | 1 | 5% |
Unknown | 6 | 27% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 17 | 77% |
Scientists | 3 | 14% |
Practitioners (doctors, other healthcare professionals) | 2 | 9% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 273 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 35 | 13% |
Other | 34 | 12% |
Student > Master | 21 | 8% |
Student > Ph. D. Student | 18 | 7% |
Student > Bachelor | 18 | 7% |
Other | 52 | 19% |
Unknown | 95 | 35% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 91 | 33% |
Neuroscience | 35 | 13% |
Biochemistry, Genetics and Molecular Biology | 8 | 3% |
Agricultural and Biological Sciences | 6 | 2% |
Immunology and Microbiology | 6 | 2% |
Other | 19 | 7% |
Unknown | 108 | 40% |