MOG-IgG testing strategies in accordance with the 2023 MOGAD criteria: a clinical-laboratory assessment.
J Neurol
; 271(5): 2840-2843, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38280000
ABSTRACT
BACKGROUND:
Live cell-based assay (LCBA) is the gold standard for MOG-IgG detection, and fixed CBA (FCBA) is a widely used commercial alternative. Recent criteria attributed a diagnostic value to MOG-IgG titration with both LCBA and FCBA, with low-titre samples requiring additional supporting features for MOGAD diagnosis. However, FCBA titration is not validated. We aimed to assess the impact of the criteria-based MOG-IgG testing in MOGAD diagnosis.METHODS:
Thirty-eight serum samples of LCBA MOG-IgG1-positive MOGAD patients were titred on MOG-IgG LCBA and FCBA, and the presence of supporting features for MOGAD assessed. MOGAD criteria were evaluated in four testing scenarios (a) FCBA without titration; (b) FCBA with titration; c) LCBA without titration; (d) LCBA with titration.RESULTS:
FCBA without titration failed to reach MOGAD diagnosis in 11/38 patients (28.9%, negative results in 5, lack of supporting features in 6). Patients with unconfirmed diagnosis had optic neuritis (ON, n = 8), or transverse myelitis (TM, n = 3). FCBA with titration allowed MOGAD diagnosis in 4 additional patients. Correlation between LCBA and FCBA titres was moderate (Spearman's rho 0.6, p < 0.001).CONCLUSIONS:
FCBA yields high rate of misdiagnosis mainly due a lower analytical sensitivity. FCBA titration provides a moderate diagnostic advantage in FCBA positive patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Doenças Autoimunes
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Imunoglobulina G
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Glicoproteína Mielina-Oligodendrócito
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article