In: Journal of Neuroinflammation, 15 (2018), Nr. 134. pp. 1-10. ISSN 1742-2094
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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.
Document type: | Article |
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Journal or Publication Title: | Journal of Neuroinflammation |
Volume: | 15 |
Number: | 134 |
Publisher: | BioMed Central |
Place of Publication: | London |
Date Deposited: | 30 May 2018 09:48 |
Date: | 2018 |
ISSN: | 1742-2094 |
Page Range: | pp. 1-10 |
Faculties / Institutes: | Medizinische Fakultät Heidelberg > Neurologische Universitätsklinik |
DDC-classification: | 610 Medical sciences Medicine |