DIAGNOSTIC TEST 880

Aquaporin 4 (AQP4) Antibodies  (IgG)

Diagnostic test for antibodies against AQP4. For suspected Neuromyelitis Optica (NMO).

Indication

Suspicion of Neuromyelitis Optica Spectrum Disorder (NMOSD)

Sample material

Serum

  • Minim. volume: 0,5 mL

CSF

  • Minim. volume: 0,5 mL

Transport

Within Sweden

  • room temperature

International

  • cold

Method

Cell-based assay (CBA), indirect immunofluorescence (IIF)

Reference interval

  • Serum: <1:10 negative
  • CSF: negative

Result

Results are reported as negative or positive. A positive result is followed by a titer (serum).

Interpretation

IgG antibodies against AQP4 are a strong marker for Neuromyelitis optica spectrum disorder (NMOSD).

If clinical suspicion of NMOSD remains after a negative result, complementary analysis with live Cell Based Assay (live CBA) is recommended in serum.

The recommendation is to test for anti-AQP4 antibodies only in serum, but there are isolated cases where anti-AQP4 antibodies have only been detected in CSF. The clinical relevance of antibodies in CSF is unclear and the diagnostic criteria are based on analysis of serum.

References

  • Sato DK et al. Neurology. 2014. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. PMID: 24415568
  • Reindl M et al. Neurol Neuroimmunol Neuroinflamm. 2020. International multicenter examination of MOG antibody assays. PMID: 32024795
  • Majed M et al. Neurol Neuroimmunol Neuroinflamm. 2016. Clinical utility of testing AQP4-IgG in CSF: Guidance for physicians. PMID: 27144221
  • Höftberger R et al. Mult Scler. 2015. Antibodies to MOG and AQP4 in adults with neuromyelitis optica and suspected limited forms of the disease. PMID: 25344373
  • Wingerchuk DM et al. Neurology. 2015. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. PMID: 26092914
  • Lycke J, Malmeström C. Lakartidningen. 2010. Neuromyelitis optica--viktig differentialdiagnos till MS. Tidigt insatt behandling avgörande för prognosen. PMID: 21294335
  • Banwell B et al. Lancet Neurol. 2023. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria. PMID: 36706773
  • Paul F et al. Neurol Neuroimmunol Neuroinflamm. 2023. International Delphi Consensus on the Management of AQP4-IgG+ NMOSD: Recommendations for Eculizumab, Inebilizumab, and Satralizumab. PMID: 37258412
  • Petzold A et al. Lancet Neurol. 2022. Diagnosis and classification of optic neuritis. PMID: 36179757

Included in these panels

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How to order

This test is available worldwide for hospitals, clinics, and physicians.

  1. Print and complete the request form

    Download the request form. Clearly state the name and phone number of the referring hospital, clinic, or physician.

  2. Prepare your samples

    Serum: At least 0.5 mL serum (plain serum tubes without additives).
    CSF: At least 0.5 mL CSF (polypropylene tubes).

  3. Send samples and request form

    Within Sweden
    Samples can be sent at room temperature to:
    Envelopes and smaller boxes:
    Wieslab AB, Box 50117, 20211 Malmö, Sweden

    Larger boxes and frozen samples:
    Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden

    International
    Send samples cold to:
    Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden

Read our sampling instructions for more information

Last updated: 2025-08-18