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J Neurol. 2017 Oct;264(10):2088-2094. doi: 10.1007/s00415-017-8596-7. Epub 2017 Aug 24.

What proportion of AQP4-IgG-negative NMO spectrum disorder patients are MOG-IgG positive? A cross sectional study of 132 patients.

Author information

1
The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK.
2
Institute of Infectious Disease and Global Health, University of Liverpool, The Walton Centre NHS Foundation Trust, Liverpool, UK.
3
The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK. anu.jacob@thewaltoncentre.nhs.uk.

Abstract

Antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) have been described in patients with neuromyelitis optica spectrum disorders (NMOSD) without aquaporin-4 antibodies (AQP4-IgG). We aimed to identify the proportion of AQP4-IgG-negative NMOSD patients who are seropositive for MOG-IgG. In a cross sectional study, we reviewed all patients seen in the National NMO clinic over the last 4 years (after the availability of MOG-IgG testing), including clinical information, MRI, and antibody tests. 261 unique patients were identified. 132 cases satisfied the 2015 NMOSD diagnostic criteria. Of these, 96 (73%) were AQP4-IgG positive and 36 (27%) were AQP4-IgG negative. These 36 patients were tested for MOG-IgG and 15/36 (42%) tested positive. 20% (25/125) of the patients who did not satisfy NMOSD criteria had MOG-IgG. Approximately half of seronegative NMOSD is MOG-Ig seropositive and one in five of non-NMOSD/non-MS demyelination is MOG-IgG positive. Since MOG-associated demyelinating disease is likely different from AQP4-IgG disease in terms of underlying disease mechanisms, relapse risk and possibly treatment, testing for MOG-IgG in patients with AQP4-IgG-negative NMOSD and other non-MS demyelination may have significant implications to management and clinical trials.

KEYWORDS:

Aquaporin-4 antibodies; Myelin oligodendrocytes glycoprotein; Neuromyelitis optica

PMID:
28840314
PMCID:
PMC5617862
DOI:
10.1007/s00415-017-8596-7
[Indexed for MEDLINE]
Free PMC Article

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