j -神经科j -神经科SP - e1095 LP - e1108 DO - 10.1212/WNL.0000000000201662首页六世- 100 - 11 Cobo卡尔沃盟盟-萨拉的法令盟阿尔瓦罗·艾伯特-泰国人Armangue盟Saiz AU -基督教莱希AU -凯文Rostasy AU -马库斯Breu AU -马蒂亚斯•鲍曼盟和平Hoftberger AU - Ilya Ayzenberg盟卡罗琳Schwake AU -玛丽亚赛盟Eugenia马丁斯盟-吉玛Olive-Cirera AU -乔治娜Arrambide盟- Mar Tintore盟-拉斐尔Bernard-Valnet AU - Renaud Du Pasquier盟Fabienne Brilot盟Sudarshini拉马纳坦盟Alberto Gajofatto——凯瑟琳Schanda盟AU -塞尔吉奥·法拉利盟伊利亚Sechi AU - Eoin p·弗拉纳根AU -肖恩·j·Pittock盟Vyanka Redenbaugh AU -马库斯Reindl盟Romain Marignier AU -萨拉Mariotto Y1 - 2023/03/14 UR - //www.ez-admanager.com/content/100/11/e1095.abstract首页 N2 -背景和目标虽然髓少突细胞糖蛋白antibody-associated疾病的诊断(MOGAD)是基于血清MOG抗体(MOG-Abs)积极性,患者共存或限制MOG-Abs CSF已报告。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)。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%对3%的儿童)，更常见于运动(n = 14, 45%)和感觉症状(n = 13, 42%)，除4例(2例多发性硬化症，1例多发性神经根炎和1例Susac综合征)外，所有患者的最终诊断与MOGAD相符。当根据MOG-Abs CSF状态对血清阳性患者进行比较时，MOG-Abs血清阳性和CSF阳性患者在指数事件中最低时具有更高的扩展残疾状态量表(EDSS)(中位数为4.5，四分位数范围[IQR] 3.0 - 7.5 vs 3.0, IQR 2.0-6.8, p = 0.007)，并且比MOG-Abs血清阳性和CSF阴性患者更常见地出现感觉症状(45.5% vs 24%， p = 0.002)，运动症状(33.6% vs 19%， p = 0.021)和约(26.9% vs 7.8%， p = 0.001)。 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 ER -