Evaluation of diagnostic criteria and red flags of myelin oligodendrocyte glycoprotein encephalomyelitis in a clinical routine cohort.

Veselaj, Krenar; Kamber, Nicole; Briner, Myriam; Friedli, Christoph; Diem, Lara; Guse, Kirsten; Miclea, Andrei; Wiest, Roland; Wagner, Franca; Grabe, Hilary; Abegg, Mathias; Horn, Michael P.; Bigi, Sandra; Chan, Andrew; Hoepner, Robert; Salmen, Anke (2021). Evaluation of diagnostic criteria and red flags of myelin oligodendrocyte glycoprotein encephalomyelitis in a clinical routine cohort. CNS neuroscience & therapeutics, 27(4), pp. 426-438. Wiley 10.1111/cns.13461

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AIMS

Myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) have been proposed to define "MOG encephalomyelitis" (MOG-EM), with published diagnostic and "red flag" criteria. We aimed to evaluate these criteria in a routine clinical setting.

METHODS

We retrospectively analyzed patients with borderline/positive MOG-IgG and applied the diagnostic and red flag criteria to determine likelihood of MOG-EM diagnosis. Para-/clinical parameters were described and analyzed with chi-square test.

RESULTS

In total, 37 patients fulfilled MOG-EM diagnostic criteria (female-to-male ratio: 1.6:1, median onset age: 28.0 years [IQR 18.5-40.5], n = 8 with pediatric onset). In 24/37, red flags were present, predominantly MOG-IgG at assay cutoff and/or MRI lesions suggestive of multiple sclerosis (MS). As proposed in the consensus criteria, these patients should rather be described as "possible" MOG-EM. Of these, we classified 13 patients as "unlikely" MOG-EM in the presence of the red flag "borderline MOG-IgG" with negative MOG-IgG retest or coincidence of ≥1 additional red flag. This group mainly consisted of patients diagnosed with MS (n = 11). Frequency of cerebrospinal fluid (CSF-)-specific oligoclonal bands (OCB) is significantly lower in definite vs possible and unlikely MOG-EM (P = .0005).

CONCLUSION

Evaluation of diagnostic and red flag criteria, MOG-IgG retesting (incl. change of assay), and CSF-specific OCB are relevant in clinical routine cohorts to differentiate MOG-EM from MS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Kamber, Nicole; Briner, Myriam Sandra; Friedli, Christoph Daniel; Diem, Lara; Miclea, Andrei; Wiest, Roland; Wagner, Franca; Grabe, Hilary Michelle; Abegg, Mathias; Horn, Michael; Bigi, Sandra; Chan, Andrew Hao-Kuang; Hoepner, Robert and Salmen, Anke

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1755-5949

Publisher:

Wiley

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

26 Oct 2020 07:29

Last Modified:

11 Mar 2021 01:31

Publisher DOI:

10.1111/cns.13461

PubMed ID:

33047894

Uncontrolled Keywords:

cerebrospinal fluid multiple sclerosis myelin oligodendrocyte glycoprotein neuromyelitis optica spectrum disorders

BORIS DOI:

10.7892/boris.147034

URI:

https://boris.unibe.ch/id/eprint/147034

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