MOG 抗体检测在脑脊液中的临床意义。
The clinical relevance of MOG antibody testing in cerebrospinal fluid.
机构信息
Translational Neuroimmunology Group, Kids Neuroscience Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Department of Neurology, Concord Hospital, Sydney, Australia.
出版信息
Ann Clin Transl Neurol. 2024 Sep;11(9):2514-2519. doi: 10.1002/acn3.52163. Epub 2024 Jul 28.
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.
髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）通过血清髓鞘少突胶质细胞糖蛋白免疫球蛋白 G（MOG-IgG）与典型脱髓鞘相关联进行诊断。111/1127 例配对 CSF/血清样本的患者 MOG-IgG 血清阳性。仅 1016 例（0.7%）血清阴性患者的 CSF 中存在 MOG-IgG 限制。虽然 3/7 例患者患有纵向广泛横贯性脊髓炎，但 4 例患者有明确的其他诊断（3 例多发性硬化症，1 例中枢神经系统血管炎）。在全国转诊环境中，CSF 限制的 MOG-IgG 敏感性低（2.63%，95%CI 0.55-7.50%），阳性预测值低（1.97%，95%CI 0.45-8.13%）。我们强烈建议使用血清作为首选诊断生物样本，并在没有与 MOGAD 一致的临床放射学特征的患者中对 CSF 限制的 MOG-IgG 的解释保持谨慎。
Zotero 插件