MOG-IgG testing strategies in accordance with the 2023 MOGAD criteria : a clinical-laboratory assessment
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:271 |
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| Enthalten in: |
Journal of neurology - 271(2024), 5 vom: 24. Apr., Seite 2840-2843 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Risi, Mario [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 27.04.2024 Date Revised 27.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00415-024-12180-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367704153 |
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| 100 | 1 | |a Risi, Mario |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a MOG-IgG testing strategies in accordance with the 2023 MOGAD criteria |b a clinical-laboratory assessment |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 27.04.2024 | ||
| 500 | |a Date Revised 27.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a CONCLUSIONS: FCBA yields high rate of misdiagnosis mainly due a lower analytical sensitivity. FCBA titration provides a moderate diagnostic advantage in FCBA positive patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cell-based assays | |
| 650 | 4 | |a Infammatory demyelinating diseases | |
| 650 | 4 | |a Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) | |
| 650 | 4 | |a Neuroimmunology | |
| 650 | 4 | |a Neurology | |
| 650 | 7 | |a Myelin-Oligodendrocyte Glycoprotein |2 NLM | |
| 650 | 7 | |a Immunoglobulin G |2 NLM | |
| 650 | 7 | |a Autoantibodies |2 NLM | |
| 650 | 7 | |a MOG protein, human |2 NLM | |
| 700 | 1 | |a Greco, Giacomo |e verfasserin |4 aut | |
| 700 | 1 | |a Masciocchi, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Rigoni, Eleonora |e verfasserin |4 aut | |
| 700 | 1 | |a Colombo, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Businaro, Pietro |e verfasserin |4 aut | |
| 700 | 1 | |a Scaranzin, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Morandi, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Bisecco, Alvino |e verfasserin |4 aut | |
| 700 | 1 | |a Bini, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Diamanti, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Gallo, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Franciotta, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Gastaldi, Matteo |e verfasserin |4 aut | |
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