Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders
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Abstract
Objective: To evaluate clinical features among patients with neuromyelitis optica spectrum disorders (NMOSD) who have myelin oligodendrocyte glycoprotein (MOG) antibodies, aquaporin-4 (AQP4) antibodies, or seronegativity for both antibodies.
Methods: Sera from patients diagnosed with NMOSD in 1 of 3 centers (2 sites in Brazil and 1 site in Japan) were tested for MOG and AQP4 antibodies using cell-based assays with live transfected cells.
Results: Among the 215 patients with NMOSD, 7.4% (16/215) were positive for MOG antibodies and 64.7% (139/215) were positive for AQP4 antibodies. No patients were positive for both antibodies. Patients with MOG antibodies represented 21.1% (16/76) of the patients negative for AQP4 antibodies. Compared with patients with AQP4 antibodies or patients who were seronegative, patients with MOG antibodies were more frequently male, had a more restricted phenotype (optic nerve more than spinal cord), more frequently had bilateral simultaneous optic neuritis, more often had a single attack, had spinal cord lesions distributed in the lower portion of the spinal cord, and usually demonstrated better functional recovery after an attack.
Conclusions: Patients with NMOSD with MOG antibodies have distinct clinical features, fewer attacks, and better recovery than patients with AQP4 antibodies or patients seronegative for both antibodies.
GLOSSARY
- ADEM=
- acute demyelinating encephalomyelitis;
- ANA=
- antinuclear autoantibodies;
- AQP4=
- aquaporin-4;
- CBA=
- cell-based assay;
- EDSS=
- Expanded Disability Status Scale;
- IgG=
- immunoglobulin G;
- LETM=
- longitudinally extensive transverse myelitis;
- MOG=
- myelin oligodendrocyte glycoprotein;
- MS=
- multiple sclerosis;
- NMO=
- neuromyelitis optica;
- NMOSD=
- neuromyelitis optica spectrum disorders;
- ON=
- optic neuritis
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 466
Supplemental data at www.neurology.org
- Received June 9, 2013.
- Accepted in final form September 23, 2013.
- © 2014 American Academy of Neurology
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Letters: Rapid online correspondence
- Response to: Anti-MOG+ ON: a mystery yet unknown
- Douglas K. Sato, Neurologist, Tohoku University School of Medicinedouglas.sato@med.tohoku.ac.jp
- Douglas Kazutoshi Sato, Sendai, Japan; Dagoberto Callegaro, Sao Paulo, Brazil; Marco Aurelio Lana-Peixoto, Belo Horizonte, Brazil; Ichiro Nakashima, Sendai, Japan; Kazuo Fujihara, Sendai, Japan
Submitted May 12, 2014 - Anti-MOG+ ON: a mystery yet unknown
- Xueqiang Hu, Doctor, Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen Unihuxueqiangzssy@qq.com
- Zhifeng Mao, Zhengqi Lu, Xueqiang Hu
Submitted March 11, 2014 - Response to "Existence of anti-AQP4+ and anti-MOG+ neuromyelitis optica with severe recurrent optic neuritis"
- Douglas K. Sato, Neurologist, Tohoku University School of Medicinedouglas.sato@med.tohoku.ac.jp
- Douglas Kazutoshi Sato, Sendai, Japan; Toshiyuki Takahashi, Sendai, Japan; Patrick J. Waters, Oxford, UK; Kazuo Fujihara, Sendai, Japan
Submitted February 04, 2014 - Existence of anti-AQP4+ and anti-MOG+ neuromyelitis optica with severe recurrent optic neuritis
- Takeshi Kezuka, Associate Professor, Department of Ophthalmology, Tokyo Medical Universitytkezuka@tokyo-med.ac.jp
- Takeshi Kezuka, Tokyo, Japan; Keiko Tanaka, Ishikawa, Japan; Yoshimishi Matsunaga, Tokyo, Japan; Hiroshi Goto, Tokyo, Japan
Submitted January 28, 2014
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