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. 2014 Feb 11;82(6):474-81.
doi: 10.1212/WNL.0000000000000101. Epub 2014 Jan 10.

Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders

Douglas Kazutoshi Sato  1 , Dagoberto Callegaro, Marco Aurelio Lana-Peixoto, Patrick J Waters, Frederico M de Haidar Jorge, Toshiyuki Takahashi, Ichiro Nakashima, Samira Luisa Apostolos-Pereira, Natalia Talim, Renata Faria Simm, Angelina Maria Martins Lino, Tatsuro Misu, Maria Isabel Leite, Masashi Aoki, Kazuo Fujihara
Affiliations

Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders

Douglas Kazutoshi Sato et al. Neurology. .

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.

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Figures

Figure 1
Figure 1. Bilateral optic neuritis in a patient with MOG antibodies
Axial short TI inversion recovery (STIR) and T1-weighted with gadolinium MRI of the optic nerves from a 28-year-old man with bilateral simultaneous optic neuritis and myelin oligodendrocyte glycoprotein (MOG) antibodies (titer 1:4,096) shows bilateral STIR hyperintense lesions with contrast enhancement.
Figure 2
Figure 2. Recurrent longitudinally extensive transverse myelitis in a patient with MOG antibodies
Sagittal T2-weighted MRI of the spinal cord from a 6-year-old girl with recurrent longitudinally extensive transverse myelitis and myelin oligodendrocyte glycoprotein (MOG) antibodies (titer 1:1,024) shows 2 longitudinally extensive lesions. On T1-weighted sagittal sequence, the lesion in the thoracolumbar transition shows a ring contrast enhancement.
See this image and copyright information in PMC

Comment in

References

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