The clinical relevance of MOG antibody testing in cerebrospinal fluid

the Australasian MOGAD Study Group; Snehal Shah; Marzena Fabis-Pedrini; Allan G. Kermode

doi:10.1002/acn3.52163

The clinical relevance of MOG antibody testing in cerebrospinal fluid

the Australasian MOGAD Study Group
, Snehal Shah
, Marzena Fabis-Pedrini
, Allan G. Kermode

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

11 Citations (Scopus)

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
Early online date	28 Jul 2024
DOIs	https://doi.org/10.1002/acn3.52163
Publication status	Published - Sept 2024

Funding

Funders	Funder number
NHMRC National Health and Medical Research Council	2008339

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10.1002/acn3.52163Licence: CC BY

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@article{e25ffa4547154be4a97b673430080d27,

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 = "\{the Australasian MOGAD Study Group\} and 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 Marzena Fabis-Pedrini and Anthony Fok and John, \{Nevin A.\} 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 Robert Adam and Jane Andersen and Ian Andrews and Jayne Antony and Patrick Aouad and Monica Badve and Barnett, \{Michael H.\} and Joshua Barton and Heidi Beadnall and Stefan Blum and Michael Boggild and Fabienne Brilot and Simon Broadley and Brown, \{David A.\} and Jim Burrow and Helmut Butzkueven and Katherine Buzzard and Ann Bye and Anita Cairns and Sophie Calvert and Fiona Chan and Shabeed Chelakkadan and Melissa Chu and Clark, \{Damian R.\} and Isabella Cotter and Dale, \{Russell C.\} and \{Dela Cruz\}, Fionna and Marzena Fabis-Pedrini and Deborah Field and Anthony Fok and Fraser, \{Clare L.\} and Fung, \{Victor S.C.\} and Justin Garber and Serge Geara and Deepak Gill and Sachin Gupta and Hardy, \{Todd A.\} and Simon Hawke and Henderson, \{Andrew P.D.\} and Niroshan Jeyakumar and John, \{Nevin A.\} and Jones, \{Dean L.\} and Jones, \{Hannah F.\} and Tomas Kalincik and Kermode, \{Allan G.\} and Matthew Kiernan and Trevor Kilpatrick and Chris Kneebone and Kornberg, \{Andrew J.\} and Mitchell Lawlor and Jeannette Lechner-Scott and Lee, \{Fiona X.Z.\} and Magdalena Lerch and Leventer, \{Richard J.\} and Vivien Li and Simon Ling and Ganesha Liyanage and Lopez, \{Joseph A.\} and Ma, \{Kit Kwan Margaret\} and Stephen Malone and Marriot, \{Mark P.\} and Pamela McCombe and Alan McDougall and Menezes, \{Manoj P.\} and Vera Merheb and Christina Miteff and Mastura Monif and \{Musuwadi Subramanian\}, Gopinath and Kristy Nguyen and Nguyen, \{Ai Lan\} and Gina O'Grady and John O'Neill and Robert Ouvrier and Mark Paine and John Parratt and Sekhar Pillai and Jane Prosser and Jessica Qiu and Sudarshini Ramanathan and Stephen Reddel and Molly Reynolds and Riminton, \{Sean D.S.\} and Izanne Roos and Jennifer Sandbach and Scheffer, \{Ingrid E.\} and Snehal Shah and Ubaid Shah and Neil Shuey and Adriane Sinclair and Pakeeran Siriratnam and Mark Slee and Spooner, \{Claire G.\} and Ian Sutton and Sanjay Swaminathan and Esther Tantsis and James Thomas and Terrence Thomas and Julia Thompson and Trewin, \{Benjamin P.\} and Christopher Troedson and \{Van der Walt\}, Anneke and Steve Vucic and Justine Wang and Tyson Ware and Richard Webster and Lin, \{Ming Wei\} and Owen White and Nigel Wolfe and Wei Yeh and Con Yiannikas and Yiu, \{Eppie M.\} and Michael Zhong",

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",

number = "9",

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TY - JOUR

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

AU - the Australasian MOGAD Study Group

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

AU - Fok, Anthony

AU - John, Nevin A.

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 - Adam, Robert

AU - Andersen, Jane

AU - Andrews, Ian

AU - Antony, Jayne

AU - Aouad, Patrick

AU - Badve, Monica

AU - Barnett, Michael H.

AU - Barton, Joshua

AU - Beadnall, Heidi

AU - Blum, Stefan

AU - Boggild, Michael

AU - Brilot, Fabienne

AU - Broadley, Simon

AU - Brown, David A.

AU - Burrow, Jim

AU - Butzkueven, Helmut

AU - Buzzard, Katherine

AU - Bye, Ann

AU - Cairns, Anita

AU - Calvert, Sophie

AU - Chan, Fiona

AU - Chelakkadan, Shabeed

AU - Chu, Melissa

AU - Clark, Damian R.

AU - Cotter, Isabella

AU - Dale, Russell C.

AU - Dela Cruz, Fionna

AU - Fabis-Pedrini, Marzena

AU - Field, Deborah

AU - Fok, Anthony

AU - Fraser, Clare L.

AU - Fung, Victor S.C.

AU - Garber, Justin

AU - Geara, Serge

AU - Gill, Deepak

AU - Gupta, Sachin

AU - Hardy, Todd A.

AU - Hawke, Simon

AU - Henderson, Andrew P.D.

AU - Jeyakumar, Niroshan

AU - John, Nevin A.

AU - Jones, Dean L.

AU - Jones, Hannah F.

AU - Kalincik, Tomas

AU - Kermode, Allan G.

AU - Kiernan, Matthew

AU - Kilpatrick, Trevor

AU - Kneebone, Chris

AU - Kornberg, Andrew J.

AU - Lawlor, Mitchell

AU - Lechner-Scott, Jeannette

AU - Lee, Fiona X.Z.

AU - Lerch, Magdalena

AU - Leventer, Richard J.

AU - Li, Vivien

AU - Ling, Simon

AU - Liyanage, Ganesha

AU - Lopez, Joseph A.

AU - Ma, Kit Kwan Margaret

AU - Malone, Stephen

AU - Marriot, Mark P.

AU - McCombe, Pamela

AU - McDougall, Alan

AU - Menezes, Manoj P.

AU - Merheb, Vera

AU - Miteff, Christina

AU - Monif, Mastura

AU - Musuwadi Subramanian, Gopinath

AU - Nguyen, Kristy

AU - Nguyen, Ai Lan

AU - O'Grady, Gina

AU - O'Neill, John

AU - Ouvrier, Robert

AU - Paine, Mark

AU - Parratt, John

AU - Pillai, Sekhar

AU - Prosser, Jane

AU - Qiu, Jessica

AU - Ramanathan, Sudarshini

AU - Reddel, Stephen

AU - Reynolds, Molly

AU - Riminton, Sean D.S.

AU - Roos, Izanne

AU - Sandbach, Jennifer

AU - Scheffer, Ingrid E.

AU - Shah, Snehal

AU - Shah, Ubaid

AU - Shuey, Neil

AU - Sinclair, Adriane

AU - Siriratnam, Pakeeran

AU - Slee, Mark

AU - Spooner, Claire G.

AU - Sutton, Ian

AU - Swaminathan, Sanjay

AU - Tantsis, Esther

AU - Thomas, James

AU - Thomas, Terrence

AU - Thompson, Julia

AU - Trewin, Benjamin P.

AU - Troedson, Christopher

AU - Van der Walt, Anneke

AU - Vucic, Steve

AU - Wang, Justine

AU - Ware, Tyson

AU - Webster, Richard

AU - Lin, Ming Wei

AU - White, Owen

AU - Wolfe, Nigel

AU - Yeh, Wei

AU - Yiannikas, Con

AU - Yiu, Eppie M.

AU - Zhong, Michael

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 - https://www.scopus.com/pages/publications/85200024428

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

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