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. 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

Shahd H M Hamid  1   2 , Daniel Whittam  1 , Kerry Mutch  1 , Samantha Linaker  1 , Tom Solomon  2 , Kumar Das  1 , Maneesh Bhojak  1 , Anu Jacob  3
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Free PMC article

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

Shahd H M Hamid et al. J Neurol. 2017 Oct.
Free PMC article

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.

Conflict of interest statement

Funding

The study is not industry sponsored.

Conflicts of interest

All authors declare no conflict of interest.

Ethical standards

This study meets UK ethical standards.

Figures

Fig. 1
Fig. 1
Classification of non-MS/atypical demyelination based on 2015 NMOSD criteria, AQP4-IgG, and MOG-IgG testing. NMOSD neuromyelitis optica spectrum disorder, AQP4 IgG Antibody to aquaporin 4, MOG-IgG antibody to myelin oligodendrocyte glycoprotein, OSD optico-spinal demyelination with normal brain MRI
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