Hyun Jae-Won, Chung Jieun, Payumo Rosah May Palermo, Park Na Young, Kang You-Ri, Kim Su-Hyun, Kim Ho Jin
Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea.
Chon-Nam University Hospital, Gwangju, Republic of Korea.
Eur J Neurol. 2025 Sep;32(9):e70356. doi: 10.1111/ene.70356.
Myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) positivity has been reported in some people with multiple sclerosis (pwMS), posing a diagnostic challenge. However, most studies have been conducted in predominantly Caucasian populations. We aimed to determine the frequency of MOG-IgG in a large, predominantly Asian MS cohort using a validated MOG-IgG assay.
Between 2005 and 2024, consecutive people diagnosed with MS according to the 2017 McDonald criteria were enrolled from the National Cancer Center registry. Serum samples from 405 pwMS were tested for MOG-IgG using an in-house live cell-based assay at a 1:20 dilution. Borderline or positive samples were retested at a 1:100 dilution by investigators blinded to clinical data.
Among the 405 pwMS (98% Asian, 66% female, median age at onset 28 years), the overall proportion of MOG-IgG positive or borderline results was 1.5% (n = 6). Clear MOG-IgG positivity was extremely rare (n = 1, 0.3%), though positive or borderline results at low titer only were observed in 1.2% (n = 5) of pwMS.
True MOG-IgG positivity in MS is uncommon across populations, but low titer positive or borderline results may complicate diagnosis. Comprehensive clinical assessment remains essential, and repeat testing at higher dilutions can be helpful to avoid misdiagnosis.
在一些多发性硬化症患者（pwMS）中报告了髓鞘少突胶质细胞糖蛋白免疫球蛋白G（MOG-IgG）阳性，这带来了诊断挑战。然而，大多数研究是在以白种人为主的人群中进行的。我们旨在使用经过验证的MOG-IgG检测方法，确定一个以亚洲人为主的大型多发性硬化症队列中MOG-IgG的频率。
2005年至2024年期间，从国家癌症中心登记处招募了根据2017年麦克唐纳标准连续诊断为多发性硬化症的患者。使用内部基于活细胞的检测方法，以1:20的稀释度对405例pwMS的血清样本进行MOG-IgG检测。对临界或阳性样本，由对临床数据不知情的研究人员以1:100的稀释度重新检测。
在405例pwMS（98%为亚洲人，66%为女性，发病年龄中位数为28岁）中，MOG-IgG阳性或临界结果的总体比例为1.5%（n = 6）。明确的MOG-IgG阳性极为罕见（n = = 1，0.3%），不过仅在1.2%（n = 5）的pwMS中观察到低滴度的阳性或临界结果。
多发性硬化症中真正的MOG-IgG阳性在各人群中并不常见，但低滴度阳性或临界结果可能使诊断复杂化。全面的临床评估仍然至关重要，以更高稀释度重复检测有助于避免误诊。
