Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Cumming School of Medicine, Health Sciences Centre, Room 1007C, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
J Neurol. 2024 May;271(5):2662-2671. doi: 10.1007/s00415-024-12213-7. Epub 2024 Feb 16.
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is an idiopathic central nervous system (CNS) demyelinating disease gaining recognition with wider availability of cell-based assay (CBA) testing and recently published diagnostic criteria. However, uncertainty remains regarding the interpretation of antibody titers, particularly cerebrospinal fluid (CSF) MOG antibody titers.
All MOG IgG CBA results performed by the provincial MitogenDx laboratory in Alberta from July 2017 to July 2023 were retrieved. Chart review was performed in patients with both serum and CSF testing and ≥ 1 positive MOG antibody result. Demographics, antibody titers, clinical and imaging features, treatment, and diagnosis were analyzed based on serum/CSF status.
Among 4494 MOG CBA assays, there were 413 CSF samples in 402 patients, and 268 patients had at least one associated serum sample. Mean time between CSF and serum testing was 20.9 days (range 0-870 days), most with testing within 30 days. Five of the 268 patients had serum positive/CSF positive MOG antibodies, 4 with acute disseminated encephalomyelitis and 1 with longitudinally extensive transverse myelitis. Twenty-three patients had serum positive/CSF negative MOG and 13/23 with optic neuritis. CSF MOG antibody positive patients were younger, and more likely to remain MOG seropositive versus CSF negative patients. No seronegative patient had MOG antibodies in CSF.
In province-wide testing, CSF MOG antibodies were rare, only in MOG seropositive patients and none with optic neuritis. Our study does not support a clear role for CSF MOG antibody testing in the majority of patients, although further study is required.
髓鞘少突胶质细胞糖蛋白（MOG）抗体相关疾病（MOGAD）是一种特发性中枢神经系统（CNS）脱髓鞘疾病，随着细胞检测（CBA）检测的广泛应用和最近发布的诊断标准，其得到了更多的认可。然而，对于抗体滴度的解读，尤其是脑脊液（CSF）MOG 抗体滴度，仍然存在不确定性。
检索了 2017 年 7 月至 2023 年 7 月期间，阿尔伯塔省 MitogenDx 实验室进行的所有 MOG IgG CBA 结果。对血清和 CSF 检测均为阳性且至少有 1 项 MOG 抗体阳性结果的患者进行了病历回顾。根据血清/CSF 状态分析了患者的人口统计学特征、抗体滴度、临床和影像学特征、治疗和诊断。
在 4494 项 MOG CBA 检测中，有 413 项 CSF 样本来自 402 名患者，268 名患者至少有一份相关的血清样本。CSF 和血清检测之间的平均时间为 20.9 天（范围 0-870 天），大多数在 30 天内进行。在 268 名患者中，有 5 名血清阳性/CSF 阳性 MOG 抗体，4 名患有急性播散性脑脊髓炎，1 名患有纵向广泛性横贯性脊髓炎。23 名患者血清阳性/CSF 阴性 MOG，13 名中有 13 名患有视神经炎。CSF MOG 抗体阳性患者更年轻，与 CSF 阴性患者相比，更有可能保持 MOG 血清阳性。没有血清阴性患者的 CSF 中存在 MOG 抗体。
在全省范围内的检测中，CSF MOG 抗体很少见，仅在 MOG 血清阳性患者中发现，而且没有视神经炎患者。我们的研究不支持 CSF MOG 抗体检测在大多数患者中的明确作用，尽管还需要进一步研究。
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