1. The clinical relevance of MOG antibody testing in cerebrospinal fluid
- Author
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Reynolds, M, Tan, I, Nguyen, K, Merheb, V, Lee, FXZ, Trewin, BP, Lerch, M, Shah, S, Wolfe, N, Buzzard, K, Lechner-Scott, J, Fabis-Pedrini, M, Fok, A, John, N, Kneebone, C, Yiannikas, C, Brown, DA, Kermode, AG, Reddel, S, Dale, RC, Brilot, F, Ramanathan, S, Reynolds, M, Tan, I, Nguyen, K, Merheb, V, Lee, FXZ, Trewin, BP, Lerch, M, Shah, S, Wolfe, N, Buzzard, K, Lechner-Scott, J, Fabis-Pedrini, M, Fok, A, John, N, Kneebone, C, Yiannikas, C, Brown, DA, Kermode, AG, Reddel, S, Dale, RC, Brilot, F, and Ramanathan, S
- Abstract
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is diagnosed by serum MOG-immunoglobulin G (MOG-IgG) in association with typical demyelination. 111/1127 patients with paired CSF/serum samples were seropositive for MOG-IgG. Only 7/1016 (0.7%) seronegative patients had CSF-restricted MOG-IgG. While 3/7 patients had longitudinally extensive transverse myelitis, four had a confirmed alternate diagnosis (three multiple sclerosis, one CNS vasculitis). In a national referral setting, CSF-restricted MOG-IgG had a low sensitivity (2.63%, 95%CI 0.55-7.50%) and low positive predictive value (1.97%, 95%CI 0.45-8.13%). We strongly recommend serum as the preferred diagnostic biospecimen, and urge caution in the interpretation of CSF-restricted MOG-IgG in patients without clinico-radiological features consistent with MOGAD.
- Published
- 2024