基于2023年MOGAD诊断标准的MOG-IgG检测的阳性预测值。
The positive predictive value of MOG-IgG testing based on the 2023 diagnostic criteria for MOGAD.
作者信息
Nguyen Linda, Singh Sumit, Feltrin Fabricio S, Tardo Lauren M, Clarke Rebekah L, Wang Cynthia X, Greenberg Benjamin M
机构信息
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
Mult Scler J Exp Transl Clin. 2024 Aug 14;10(3):20552173241274610. doi: 10.1177/20552173241274610. eCollection 2024 Jul-Sep.
BACKGROUND
Myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) is a relatively new disease entity in the field of demyelinating disorders. Its first diagnostic criteria have recently been published.
OBJECTIVES
We evaluated the positive predictive value (PPV) for MOG-IgG testing and report the clinical and radiologic features with respect to the recently published criteria.
METHODS
A retrospective study was conducted at three centers in Dallas, Texas. Patients with positive MOG-IgG testing on cell-based assays at any time were included. Positive cases were reviewed by at least two neuroimmunologists for fulfillment of the criteria.
RESULTS
We included 235 patients. The PPV of seropositivity at any time was 78.3% overall, 52.6% for low titer, and 90.1% for high titer. Children had a higher PPV than adults (93.9% versus 67.2%). Positive predictive value was 6.3% in those without a core clinical demyelinating attack. Children more often have the typical imaging features of MOGAD in optic neuritis than adults.
CONCLUSIONS
We report a PPV of 78.3% for MOG-IgG testing using the 2023 MOGAD diagnostic criteria. Children had higher PPV and frequency of supporting imaging features. Careful consideration is necessary when assigning patients with no core demyelinating event and low titers a MOGAD diagnosis.
背景
髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）是脱髓鞘疾病领域中一个相对较新的疾病实体。其首个诊断标准最近已发布。
目的
我们评估了MOG-IgG检测的阳性预测值（PPV），并根据最近发布的标准报告临床和影像学特征。
方法
在得克萨斯州达拉斯的三个中心进行了一项回顾性研究。纳入任何时候基于细胞检测MOG-IgG呈阳性的患者。阳性病例由至少两名神经免疫学家进行审查，以确定是否符合标准。
结果
我们纳入了235例患者。总体而言，任何时候血清阳性的PPV为78.3%，低滴度为52.6%，高滴度为90.1%。儿童的PPV高于成人（93.9%对67.2%）。在没有核心临床脱髓鞘发作的患者中，阳性预测值为6.3%。与成人相比，儿童在视神经炎中更常具有MOGAD的典型影像学特征。
结论
我们报告使用2023年MOGAD诊断标准进行MOG-IgG检测的PPV为78.3%。儿童的PPV和支持性影像学特征的频率更高。对于没有核心脱髓鞘事件且滴度低的患者诊断为MOGAD时，需要仔细考虑。
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