HT07.03 - Prevalence of MOG-Ab in a large cohort of neurological patients
Myelin oligodendrocyte glycoprotein (MOG) antibody disease is recognized as a distinct nosological entity. In adults, MOG IgG serum antibodies (MOG-Ab) are associated with neuromyelitis optica spectrum disorder (NMOSD) phenotype in particular isolated myelitis and recurrent often bilateral anterior optic neuritis. In children, MOG-Ab are primarily associated with acute disseminated encephalomyelitis. However, an increasing number of clinical phenotypes have been reported to be associated with MOG-Ab.
To investigate the seroprevalence of MOG-Ab under consideration of demographics, disease entities and time course in a large cohort of neurological patients.
Blood samples of 2103 consecutive adult neurologic patients admitted to the neurological department of the Technical University of Munich between 2016-2019 were tested for MOG-IgG using a cell-based assay. In a subgroup of patients, MOG Ab-persistence was analyzed in follow-up samples. For validation selected positive samples were sent to two external laboratories.
We found MOG-Ab in 28 of 2103 (1.33%) patients. High Ab-titers were rare but mostely associated with NMOSD phenotype (8/28), whereas low titers occurred in a wide range of neurological diseases, predominantly in other inflammatory CNS diseases (5/28) and stroke (6/28). Female gender and younger age at disease onset tended to be associated with higher MOG Ab-titers. Follow-up analyzes yielded Ab-persistence over time occurring not only in NMOSD but also in other neurological diseases. External validation confirmed high sensitivity and specificity of our cell-based assay for high titers but considerable variability for low MOG-Ab titer between laboratories.
The present study demonstrates of the occurrence of MOG-Ab in a wide range of neurological diseases. High Ab-titers seem to be specific for NMOSD in adults. Persistent low titer MOG-Ab are also found in non-inflammatory neurological diseases implying that their use for diagnostic purposes is highly limited.