Alkabie Samir, Budhram Adrian
Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada.
Deparment of Pathology and Laboratory Medicine, London Health Sciences Centre, Western University, London, ON, Canada.
Front Neurol. 2022 May 20;13:912050. doi: 10.3389/fneur.2022.912050. eCollection 2022.
Autoimmune myelopathies are immune-mediated disorders of the spinal cord that can cause significant neurologic disability. Discoveries of antibodies targeting aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) have facilitated the diagnosis of autoimmune myelopathies that were previously considered to be atypical presentations of multiple sclerosis (MS) or idiopathic, and represent major advancements in the field of autoimmune neurology. The detection of these antibodies can substantially impact patient diagnosis and management, and increasing awareness of this has led to a dramatic increase in testing for these antibodies among patients with suspected autoimmune myelopathy. In this review we discuss test methodologies used to detect these antibodies, the role of serum vs. cerebrospinal fluid testing, and the value of antibody titers when interpreting results, with the aim of helping laboratorians and clinicians navigate this testing when ordered as part of the diagnostic evaluation for suspected autoimmune myelopathy.
自身免疫性脊髓病是由免疫介导的脊髓疾病，可导致严重的神经功能残疾。针对水通道蛋白4（AQP4-IgG）和髓鞘少突胶质细胞糖蛋白（MOG-IgG）的抗体的发现，促进了对自身免疫性脊髓病的诊断，这些疾病以前被认为是多发性硬化症（MS）的非典型表现或特发性疾病，代表了自身免疫神经病学领域的重大进展。这些抗体的检测可对患者的诊断和管理产生重大影响，对此认识的提高导致疑似自身免疫性脊髓病患者中这些抗体检测的显著增加。在本综述中，我们讨论了用于检测这些抗体的测试方法、血清与脑脊液检测的作用以及解释结果时抗体滴度的价值，旨在帮助实验室人员和临床医生在将其作为疑似自身免疫性脊髓病诊断评估的一部分进行检测时，顺利开展此项检测。
