| Affiliation: | 1. Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;2. Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;3. Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;4. Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;5. Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Department of Pediatrics, Division of Child Neurology, University Children’s Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland |
| Abstract: | AimsMyelin oligodendrocyte glycoprotein antibodies (MOG‐IgG) have been proposed to define “MOG encephalomyelitis” (MOG‐EM), with published diagnostic and “red flag” criteria. We aimed to evaluate these criteria in a routine clinical setting.MethodsWe retrospectively analyzed patients with borderline/positive MOG‐IgG and applied the diagnostic and red flag criteria to determine likelihood of MOG‐EM diagnosis. Para‐/clinical parameters were described and analyzed with chi‐square test.ResultsIn total, 37 patients fulfilled MOG‐EM diagnostic criteria (female‐to‐male ratio: 1.6:1, median onset age: 28.0 years [IQR 18.5‐40.5], n = 8 with pediatric onset). In 24/37, red flags were present, predominantly MOG‐IgG at assay cutoff and/or MRI lesions suggestive of multiple sclerosis (MS). As proposed in the consensus criteria, these patients should rather be described as “possible” MOG‐EM. Of these, we classified 13 patients as “unlikely” MOG‐EM in the presence of the red flag “borderline MOG‐IgG” with negative MOG‐IgG retest or coincidence of ≥1 additional red flag. This group mainly consisted of patients diagnosed with MS (n = 11). Frequency of cerebrospinal fluid (CSF‐)—specific oligoclonal bands (OCB) is significantly lower in definite vs possible and unlikely MOG‐EM (P = .0005).ConclusionEvaluation of diagnostic and red flag criteria, MOG‐IgG retesting (incl. change of assay), and CSF‐specific OCB are relevant in clinical routine cohorts to differentiate MOG‐EM from MS. |
