MOG encephalomyelitis: international recommendations on diagnosis and antibody testing

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

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Pages (from-to)134
JournalJournal of Neuroinflammation
Volume15
Issue number1
DOIs
Publication statusPublished - May 3 2018

Fingerprint Dive into the research topics of 'MOG encephalomyelitis: international recommendations on diagnosis and antibody testing'. Together they form a unique fingerprint.

Cite this