Vial

INDIVIDUAL TEST 884

Myelin oligodendrocyte glycoprotein (MOG) antibodies (ADEM)

Indication Suspicion of Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO). 

Method Indirect immunofluorescens (IIF) with MOG-transfected cells. 

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

Interpretation Myelin oligodendrocyte glycoprotein is expressed on the myelin sheath. Increased levels of antibodies against MOG may occur at very low frequency in multiple sclerosis but should be tested in anti-aquaporin 4-negative patients where Neuromyelitis optica/Neuromyelitis optica spectrum disorders (NMO/NMOSD) is suspected. 

Detection of antibodies against MOG has been found to be more sensitive in serum when compared to CSF. In patients with high levels of anti-MOG antibodies in blood, they can sometimes also be detected in CSF, suggesting passage of the antibodies from blood across the blood-brain barrier. The significance of anti-MOG antibodies in CSF is unclear. 

Antibodies against MOG are graded as Lower-risk antibodies with only 5 reported cases of underlying cancer and a positive result yields 0 points PNS score, according to Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. 

References 
  • Sato DK et al. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. Neurology 82 (2014) 474-481. 
  • Reindl M et al. International multicenter examination of MOG antibody assays. Neurol Neuroimmunol Neuroinflamm. 2020 Feb 5;7(2): e674 
  • Franziska Di Pauli et al. Temporal dynamics of anti-MOG antibodies in CNS demyelinating diseases. Clinical Immunology (2011)138, 247–254. 
  • Höftberger R et al. Antibodies to MOG and AQP4 in adults with neuromyelitis optica and suspected limited forms of the disease. Mult Scler. 2015 Jun;21(7):866-74. 
  • Wingerchuck DM et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul 14;85(2): 177-89. 
  • Klawiter E.C. et al. NMO-IgG detected in CSF in seronegative neuromyelitis optica. Neurology 72 March 24, 2009 
  • Lennon VA, Wingerchuk DM, Kryzer J, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364:2106-12. 
  • Lycke J, Malmestrom C. Neuromyelitis optica – viktig differentialdiagnos till MS. Läkartidningen 2010; 107: 3212-3215 
  • Sellner J. et al. EFNS guidelines on diagnosis and management of neuromyelitis. European Journal of Neurology 2010, 17: 1019–1032. 
  • Weinshenker BG, Wingerchuk DM, Pittock SJ, Lucchinetti CF, Lennon VA. NMO-IgG: a specific biomarker for neuromyelitis optica. Dis Markers. 2006;22(4):197-206 
  • Graus F, et al. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol Neuroimmunol Neuroinflamm. 2021 May 18;8(4):e1014. PMID: 34006622 

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Vial

ENSKILD ANALYS 884

Myelin oligodendrocyt glykoprotein/MOG-antikroppar (ADEM)

Indikation Misstanke om Multipel Skleros (MS) och Neuromyelitis Optica (NMO). 

Metod Indirekt immunofluorescens (IIF) med MOG-transfekterade celler. 

Svar Resultatet anges som negativt eller positivt. Positivt resultat titreras (serum). 

Tolkning Myelin oligodendrocyt glykoprotein (MOG) uttrycks på ytan av myelin. Förhöjd nivå av IgG-antikroppar mot MOG är ovanligt vid multipel skleros (MS) men kan påvisas i en del fall med anti-AQP4-negativ Neuromyelitis optica/Neuromyelitis optica spectrum disorders (NMO/NMOSD). 

Detektion av antikroppar mot MOG har högre sensitivitet i serum jämfört med CSF. Anti-MOG antikroppar har detekterats i CSF hos seropositiva patienter med höga antikroppstitrar, vilket föreslår en perifer produktion av anti-MOG IgG. Diagnos relevans av anti-MOG antikroppar i CSF är oklart. 

Antikropparna riktade mot MOG bedöms vara Lower-risk antibodies med endast 5 rapporterade fall med en underliggande cancer och positivitet ger 0 poäng i PNS score enligt Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. 

Referenser 
  • Sato DK et al. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. Neurology 82 (2014) 474-481. 
  • Reindl M et al. International multicenter examination of MOG antibody assays. Neurol Neuroimmunol Neuroinflamm. 2020 Feb 5;7(2): e674 
  • Franziska Di Pauli et al. Temporal dynamics of anti-MOG antibodies in CNS demyelinating diseases. Clinical Immunology (2011)138, 247–254. 
  • Höftberger R et al. Antibodies to MOG and AQP4 in adults with neuromyelitis optica and suspected limited forms of the disease. Mult Scler. 2015 Jun;21(7):866-74. 
  • Wingerchuck DM et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul 14;85(2): 177-89. 
  • Klawiter E.C. et al. NMO-IgG detected in CSF in seronegative neuromyelitis optica. Neurology 72 March 24, 2009 
  • Lennon VA, Wingerchuk DM, Kryzer J, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364:2106-12. 
  • Lycke J, Malmestrom C. Neuromyelitis optica – viktig differentialdiagnos till MS. Läkartidningen 2010; 107: 3212-3215 
  • Sellner J. et al. EFNS guidelines on diagnosis and management of neuromyelitis. European Journal of Neurology 2010, 17: 1019–1032. 
  • Weinshenker BG, Wingerchuk DM, Pittock SJ, Lucchinetti CF, Lennon VA. NMO-IgG: a specific biomarker for neuromyelitis optica. Dis Markers. 2006;22(4):197-206 
  • Graus F, et al. Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol Neuroimmunol Neuroinflamm. 2021 May 18;8(4):e1014. PMID: 34006622 

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