@article {Cartae1095,作者:萨拉·卡尔塔、伊瓦罗·科博·卡尔沃、萨·阿尔曼古、阿尔伯特·塞兹、克里斯蒂安·莱希纳、凯文·罗斯特·阿曼西、马库斯·布鲁、马蒂亚斯·鲍曼、罗曼娜·哈·阿·弗特伯格、伊尔亚·艾曾伯格、卡罗琳·施韦克、玛丽亚·塞普尔维达、尤金尼亚·玛·阿·内斯·赫恩·南德斯、杰玛·奥利夫·西雷拉、乔治娜·阿兰比德、马丁·丁托、拉斐尔·伯纳德·瓦尔内、雷诺·杜·帕斯基耶、法比安·布里奥、苏达什尼·拉马纳坦、凯瑟琳·尚达和阿尔贝托Gajofatto, Sergio Ferrari, Elia Sechi, Eoin P. Flanagan, Sean J. Pittock, Vyanka Redenbaugh, Markus Reindl, Romain Marignier, Sara Mariotto，题目={髓鞘少突胶质细胞糖蛋白抗体在脑脊液中的意义}，卷={100}，数={11}，页= {e1095—e1108}，年= {2023}，doi = {10.1212/WNL。背景与目的虽然髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)的诊断是基于血清MOG抗体(MOG- abs)阳性，但已有报道患者脑脊液中存在共存或限制性MOG- abs。首页本研究的目的是描述脑脊液MOG-Abs阳性在临床实践中的相关性。方法采用活细胞法回顾性收集疑似炎性中枢神经系统疾病且血清和/或脑脊液中MOG-Abs阳性的成人和儿童患者的临床和实验室资料。比较采用参数或非参数检验，视情况而定。采用Cox比例风险模型和logistic回归探讨不良结局的潜在因素。结果该队列包括255例患者:139例(55%)女性和132例(52%)儿童(即18岁以下)。其中，145例(56.8%)患者血清和脑脊液中同时存在MOG-Abs (MOG-Abs血清阳性和脑脊液阳性)，79例(31%)患者仅存在血清(MOG-Abs血清阳性和脑脊液阴性)，31例(12%)患者仅存在脑脊液(MOG-Abs血清阴性和脑脊液阳性)。MOG-Abs血清阴性和CSF阳性在成人中占主导地位(22% vs 3%的儿童)，更常见的是运动(n = 14.45%)和感觉症状(n = 13.42%)，除4例(2例多发性硬化症，1例多根神经炎和1例Susac综合征)外，所有患者的最终诊断与MOGAD相符。 When comparing seropositive patients according to MOG-Abs CSF status, MOG-Abs seropositive and CSF positive patients had a higher Expanded Disability Status Scale (EDSS) at nadir during the index event (median 4.5, interquartile range [IQR] 3.0{\textendash}7.5 vs 3.0, IQR 2.0{\textendash}6.8, p = 0.007) and presented more commonly with sensory (45.5\% vs 24\%, p = 0.002), motor (33.6\% vs 19\%, p = 0.021), and sphincter symptoms (26.9\% vs 7.8\%, p = 0.001) than MOG-Abs seropositive and CSF negative. At the last follow-up, MOG-Abs seropositive and CSF positive cases had more often persistent sphincter dysfunction (17.3\% vs 4.3\%, p = 0.008). Compared with seropositive patients, those MOG-Abs seronegative and CSF positive had higher disability at the last follow-up (p <= 0.001), and MOG-Abs seronegative and CSF positive status were independently associated with an EDSS >=3.0.Discussion Paired serum and CSF MOG-Abs positivity are common in MOGAD and are associated with a more severe clinical presentation. CSF-only MOG-Abs positivity can occur in patients with a phenotype suggestive of MOGAD and is associated with a worse outcome. Taken together, these data suggest a clinical interest in assessing CSF MOG-Abs in patients with a phenotype suggestive of MOGAD, regardless of the MOG-Abs serostatus.Abs=antibodies; ADEM=acute disseminated encephalomyelitis; ARR=annualized relapse rate; CBA=cell-based assays; CNS=central nervous system; CI=confidence interval; DMD=disease-modifying drug; EDSS=Expanded Disability Status Scale; IF=immunofluorescence; IQR=interquartile range; MOG=myelin oligodendrocyte glycoprotein; MOG-Abs=MOG antibodies; MOGAD=myelin oligodendrocyte glycoprotein antibody associated disease; MS=multiple sclerosis; NMOSD=neuromyelitis optica spectrum disorder; OR=odds ratio}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/100/11/e1095}, eprint = {//www.ez-admanager.com/content/100/11/e1095.full.pdf}, journal = {Neurology} }