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Neuromyelitis optica spectrum disorders: comparison of clinical and magnetic resonance imaging characteristics of AQP4‐IgG versus MOG‐IgG seropositive cases in the Netherlands
Author(s) -
Pelt E. D.,
Wong Y. Y. M.,
Ketelslegers I. A.,
Hamann D.,
Hintzen R. Q.
Publication year - 2016
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12898
Subject(s) - neuromyelitis optica , medicine , spectrum disorder , magnetic resonance imaging , immunoglobulin g , pathology , nuclear magnetic resonance , antibody , immunology , radiology , psychiatry , physics
Background and purpose Neuromyelitis optica spectrum disorders (NMOSDs) are a group of rare inflammatory demyelinating disorders of the central nervous system. The identification of specific antibodies directed to aquaporin 4 (AQP4‐IgG) led to the distinction from multiple sclerosis. However, up to 25% of the clinically diagnosed NMO patients are seronegative for AQP4‐IgG. A subgroup of these patients might be identified by antibodies directed to myelin oligodendrocyte glycoprotein (MOG‐IgG). Our objective was to investigate whether the clinical characteristics of these patients differ. Methods Using a cell‐based assay, samples of 61 AQP4‐IgG seronegative patients and 41 AQP4‐IgG seropositive patients with clinically NMOSD were analysed for the presence of MOG‐IgG. Clinical characteristics of the AQP4‐IgG, MOG‐IgG seropositive and double seronegative NMOSD patients were compared. Results Twenty of the 61 AQP4‐IgG seronegative patients tested MOG‐IgG seropositive (33%). MOG‐IgG seropositive patients were more frequently males in contrast to AQP4‐IgG seropositive patients (55% vs. 15%, P < 0.01) and Caucasians (90% vs. 63%, P = 0.03). They more frequently presented with coincident optic neuritis and transverse myelitis (40% vs. 12%, P = 0.02) and had a monophasic disease course (70% vs. 29%, P < 0.01). AQP4‐IgG seropositive patients were 2.4 times more likely to suffer from relapses compared with MOG‐IgG seropositive patients (relative risk 2.4, 95% confidence interval 1.2–4.7). AQP4‐IgG seropositive patients had higher Expanded Disability Status Scale levels at last follow‐up ( P < 0.01). Conclusion Antibodies directed to MOG identify a subgroup of AQP4‐IgG seronegative NMO patients with generally a favourable monophasic disease course.