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 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; Robert Adam; Jane Andersen; Ian Andrews; Jayne Antony; Patrick Aouad; Monica Badve; Michael H. Barnett; Joshua Barton; Heidi Beadnall; Stefan Blum; Michael Boggild; Fabienne Brilot; Simon Broadley; David A. Brown; Jim Burrow; Helmut Butzkueven; Katherine Buzzard; Ann Bye; Anita Cairns; Sophie Calvert; Fiona Chan; Shabeed Chelakkadan; Melissa Chu; Damian R. Clark; Isabella Cotter; Russell C. Dale; Fionna Dela Cruz; Sanjay Swaminathan

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 Fabis-Pedrini, Anthony Fok, Nevin John, Chris Kneebone, Con Yiannikas, David A. Brown, Allan G. Kermode, Stephen Reddel, Russell C. DaleFabienne Brilot, Sudarshini Ramanathan, Robert Adam, Jane Andersen, Ian Andrews, Jayne Antony, Patrick Aouad, Monica Badve, Michael H. Barnett, Joshua Barton, Heidi Beadnall, Stefan Blum, Michael Boggild, Fabienne Brilot, Simon Broadley, David A. Brown, Jim Burrow, Helmut Butzkueven, Katherine Buzzard, Ann Bye, Anita Cairns, Sophie Calvert, Fiona Chan, Shabeed Chelakkadan, Melissa Chu, Damian R. Clark, Isabella Cotter, Russell C. Dale, Fionna Dela Cruz, Sanjay Swaminathan

School of Medicine

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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., Fok, A., John, N., Kneebone, C., Yiannikas, C., Brown, D. A., Kermode, A. G., Reddel, S., ... Swaminathan, S. (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{a81527f9288449578ad362cf6103174b,

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 Marzena Fabis-Pedrini 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 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 Sanjay Swaminathan",

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 Inc.",

number = "9",

}

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, M, Fok, A, John, N, Kneebone, C, Yiannikas, C, Brown, DA, Kermode, AG, Reddel, S, Dale, RC, Brilot, F, Ramanathan, S, Adam, R, Andersen, J, Andrews, I, Antony, J, Aouad, P, Badve, M, Barnett, MH, Barton, J, Beadnall, H, Blum, S, Boggild, M, Brilot, F, Broadley, S, Brown, DA, Burrow, J, Butzkueven, H, Buzzard, K, Bye, A, Cairns, A, Calvert, S, Chan, F, Chelakkadan, S, Chu, M, Clark, DR, Cotter, I, Dale, RC, Dela Cruz, F & Swaminathan, S 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

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 - 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 - Swaminathan, Sanjay

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

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