Neuroimmunology Unit, Department of Neurosciences, Hospital Aleman, Buenos Aires, Argentina.
Neurology Department, Dr. Ramón Carrillo Central Hospital, San Luis, Argentina.
Eur J Neurol. 2024 Dec;31(12):e16445. doi: 10.1111/ene.16445. Epub 2024 Sep 17.
The diagnostic criteria for myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disease (MOGAD) were published in 2023. We aimed to determine the performance of the new criteria in Latin American (LATAM) patients compared with the 2018 criteria and explore the significance of MOG-IgG titers in diagnosis.
We retrospectively reviewed the medical records of LATAM (Argentina, Chile, Brazil, Peru, Ecuador, and Colombia) adult patients with one clinical MOGAD event and MOG-IgG positivity confirmed by cell-based assay. Both 2018 and 2023 MOGAD criteria were applied, calculating diagnostic performance indicators.
Among 171 patients (predominantly females, mean age at first attack = 34.1 years, mean disease duration = 4.5 years), 98.2% patients met the 2018 criteria, and of those who did not fulfill diagnostic criteria (n = 3), all tested positive for MOG-IgG (one low-positive and two without reported titer). Additionally, 144 (84.2%) patients met the 2023 criteria, of whom 57 (39.5%) had MOG-IgG+ titer information (19 clearly positive and 38 low-positive), whereas 87 (60.5%) patients had no MOG-IgG titer. All 144 patients met diagnostic supporting criteria. The remaining 27 patients did not meet the 2023 MOGAD criteria due to low MOG-IgG (n = 12) or lack of titer antibody access (n = 15), associated with the absence of supporting criteria. The 2023 MOGAD criteria showed a sensitivity of 86% (95% confidence interval = 0.80-0.91) and specificity of 100% compared to the 2018 criteria.
These findings support the diagnostic utility of the 2023 MOGAD criteria in an LATAM cohort in real-world practice, despite limited access to MOG-IgG titration.
髓鞘少突胶质细胞糖蛋白抗体（MOG-IgG）相关疾病（MOGAD）的诊断标准于 2023 年发布。我们旨在确定新的标准在拉丁美洲（LATAM）患者中的表现与 2018 年标准相比，并探讨 MOG-IgG 滴度在诊断中的意义。
我们回顾性分析了来自拉丁美洲（阿根廷、智利、巴西、秘鲁、厄瓜多尔和哥伦比亚）的 171 例成人患者的病历，这些患者均有一次临床 MOGAD 发作和通过细胞测定法证实的 MOG-IgG 阳性。应用 2018 年和 2023 年 MOGAD 标准，计算诊断性能指标。
在 171 例患者中（主要为女性，首次发病时的平均年龄为 34.1 岁，平均病程为 4.5 年），98.2%的患者符合 2018 年的标准，不符合诊断标准的 3 例患者均为 MOG-IgG 阳性（1 例低阳性，2 例未报告滴度）。此外，144 例（84.2%）患者符合 2023 年的标准，其中 57 例（39.5%）有 MOG-IgG+滴度信息（19 例明确阳性，38 例低阳性），87 例（60.5%）患者无 MOG-IgG 滴度。所有 144 例患者均符合辅助诊断标准。其余 27 例患者由于 MOG-IgG 滴度较低（n=12）或缺乏 MOG-IgG 滴度抗体检测（n=15）而不符合 2023 年 MOGAD 标准，且这些患者缺乏辅助诊断标准。与 2018 年标准相比，2023 年 MOGAD 标准的敏感性为 86%（95%置信区间为 0.80-0.91），特异性为 100%。
这些发现支持在现实世界的实践中，2023 年 MOGAD 标准在 LATAM 队列中的诊断效用，尽管 MOG-IgG 滴度检测有限。
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