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Validation of the international MOGAD panel proposed criteria: a single-centre US study
  1. Angeliki G Filippatou1,
  2. Yana Said1,
  3. Haiwen Chen1,
  4. Eleni S Vasileiou1,2,
  5. Gelareh Ahmadi1,
  6. Elias S Sotirchos1
  1. 1Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  2. 2Neurology, Mount Sinai School of Medicine, New York, New York, USA
  1. Correspondence to Dr Elias S Sotirchos, Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; ess{at}jhmi.edu

Abstract

Background Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a demyelinating disorder of the central nervous system. We aimed to evaluate the diagnostic performance of recently proposed MOGAD diagnostic criteria in a real-world patient cohort at a tertiary referral centre.

Methods We identified all patients who were evaluated at Johns Hopkins and were MOG-IgG seropositive by cell-based assay. We retrospectively applied the proposed MOGAD diagnostic criteria.

Results Among the 122 patients included in this study, 109 fulfilled the diagnostic criteria. Of 64 patients with clear positive MOG-IgG titre, 63 patients also satisfied the supporting clinical or MRI features. Of 58 patients with low positive or unknown MOG-IgG titre, 46 met criteria by fulfilment of the supporting features. The medical records were independently reviewed by two investigators with expertise in demyelinating disease, and patients were assigned empirical clinical diagnoses, with agreement with the application of the MOGAD diagnostic criteria in the majority of cases (90%).

Conclusions Our findings support the diagnostic utility of the proposed MOGAD diagnostic criteria. Patients with MOGAD met the supporting clinical or MRI features almost universally, which suggests that the criteria can be used to accurately differentiate MOGAD from mimics with low-titre MOG-IgG seropositivity.

  • neuroimmunology

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Footnotes

  • Twitter @agfilippatou, @EleniVasileiou_

  • Contributors AGF: study concept and design, major role in the acquisition of data, data analysis and interpretation, drafting and revision of the manuscript for intellectual content. YS, HC, ESV, GA: major role in the acquisition of data, revision of the manuscript for intellectual content. ESS: study concept and design, major role in the acquistion of data, data analysis and interpretation, drafting and revision of the manuscript for intellectual content.

  • Funding This work was supported by the National Institutes of Health (R25NS065729 to AGF), Siegel Rare Neuroimmune Association (HC) and Caring Friends for NMO Research Fund.

  • Competing interests ESS has received speaker honoraria from Alexion and has served on scientific advisory boards for Alexion, Horizon Therapeutics, TG Therapeutics and Roche/Genentech.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.