The clinical relevance of MOG antibody testing in cerebrospinal fluid

Molly Reynolds; Irene Tan; Kristy Nguyen; Vera Merheb; Fiona X.Z. Lee; Benjamin P. Trewin; Magdalena Lerch; Snehal Shah; Nigel Wolfe; Katherine Buzzard; Jeannette Lechner-Scott; Marzena J. Fabis-Pedrini; Anthony Fok; Nevin John; Chris Kneebone; Con Yiannikas; David A. Brown; Allan G. Kermode; Stephen Reddel; Russell C. Dale; Fabienne Brilot; Sudarshini Ramanathan; on behalf the Australasian MOGAD Study Group

doi:10.1002/acn3.52163

The clinical relevance of MOG antibody testing in cerebrospinal fluid

Molly Reynolds, Irene Tan, Kristy Nguyen, Vera Merheb, Fiona X.Z. Lee, Benjamin P. Trewin, Magdalena Lerch, Snehal Shah, Nigel Wolfe, Katherine Buzzard, Jeannette Lechner-Scott, Marzena J. Fabis-Pedrini, Anthony Fok, Nevin John, Chris Kneebone, Con Yiannikas, David A. Brown, Allan G. Kermode, Stephen Reddel, Russell C. DaleFabienne Brilot, Sudarshini Ramanathan, on behalf the Australasian MOGAD Study Group

Medicine Monash Health

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	2514-2519
Number of pages	6
Journal	Annals of Clinical and Translational Neurology
Volume	11
Issue number	9
DOIs	https://doi.org/10.1002/acn3.52163
Publication status	Published - Sept 2024

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Reynolds, M., Tan, I., Nguyen, K., Merheb, V., Lee, F. X. Z., Trewin, B. P., Lerch, M., Shah, S., Wolfe, N., Buzzard, K., Lechner-Scott, J., Fabis-Pedrini, M. J., Fok, A., John, N., Kneebone, C., Yiannikas, C., Brown, D. A., Kermode, A. G., Reddel, S., ... on behalf the Australasian MOGAD Study Group (2024). The clinical relevance of MOG antibody testing in cerebrospinal fluid. Annals of Clinical and Translational Neurology, 11(9), 2514-2519. https://doi.org/10.1002/acn3.52163

@article{33a8d4a1f61e4c0da47121baf5967287,

title = "The clinical relevance of MOG antibody testing in cerebrospinal fluid",

abstract = "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.",

author = "Molly Reynolds and Irene Tan and Kristy Nguyen and Vera Merheb and Lee, {Fiona X.Z.} and Trewin, {Benjamin P.} and Magdalena Lerch and Snehal Shah and Nigel Wolfe and Katherine Buzzard and Jeannette Lechner-Scott and Fabis-Pedrini, {Marzena J.} and Anthony Fok and Nevin John and Chris Kneebone and Con Yiannikas and Brown, {David A.} and Kermode, {Allan G.} and Stephen Reddel and Dale, {Russell C.} and Fabienne Brilot and Sudarshini Ramanathan and {on behalf the Australasian MOGAD Study Group}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.",

year = "2024",

month = sep,

doi = "10.1002/acn3.52163",

language = "English",

volume = "11",

pages = "2514--2519",

journal = "Annals of Clinical and Translational Neurology",

issn = "2328-9503",

publisher = "John Wiley & Sons",

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Reynolds, M, Tan, I, Nguyen, K, Merheb, V, Lee, FXZ, Trewin, BP, Lerch, M, Shah, S, Wolfe, N, Buzzard, K, Lechner-Scott, J, Fabis-Pedrini, MJ, Fok, A, John, N, Kneebone, C, Yiannikas, C, Brown, DA, Kermode, AG, Reddel, S, Dale, RC, Brilot, F, Ramanathan, S & on behalf the Australasian MOGAD Study Group 2024, 'The clinical relevance of MOG antibody testing in cerebrospinal fluid', Annals of Clinical and Translational Neurology, vol. 11, no. 9, pp. 2514-2519. https://doi.org/10.1002/acn3.52163

TY - JOUR

T1 - The clinical relevance of MOG antibody testing in cerebrospinal fluid

AU - Reynolds, Molly

AU - Tan, Irene

AU - Nguyen, Kristy

AU - Merheb, Vera

AU - Lee, Fiona X.Z.

AU - Trewin, Benjamin P.

AU - Lerch, Magdalena

AU - Shah, Snehal

AU - Wolfe, Nigel

AU - Buzzard, Katherine

AU - Lechner-Scott, Jeannette

AU - Fabis-Pedrini, Marzena J.

AU - Fok, Anthony

AU - John, Nevin

AU - Kneebone, Chris

AU - Yiannikas, Con

AU - Brown, David A.

AU - Kermode, Allan G.

AU - Reddel, Stephen

AU - Dale, Russell C.

AU - Brilot, Fabienne

AU - Ramanathan, Sudarshini

AU - on behalf the Australasian MOGAD Study Group

PY - 2024/9

Y1 - 2024/9

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85200024428&partnerID=8YFLogxK

U2 - 10.1002/acn3.52163

DO - 10.1002/acn3.52163

M3 - Article

C2 - 39073255

AN - SCOPUS:85200024428

SN - 2328-9503

VL - 11

SP - 2514

EP - 2519

JO - Annals of Clinical and Translational Neurology

JF - Annals of Clinical and Translational Neurology

IS - 9

ER -

The clinical relevance of MOG antibody testing in cerebrospinal fluid

Abstract

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