Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management
Abstract
:1. Introduction
2. Myelin Oligodendrocyte Glycoprotein–Structure and Function
3. Clinical Picture
3.1. ADEM Presentation
3.2. Optic Neuritis Presentation
3.3. Transverse Myelitis Presentation
3.4. Other Manifestations (Brainstem and Cortical Encephalitis)
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- clinical picture,
- -
- neuroimaging (MRI) or neurophysiological exam (in ON optical coherence tomography or visual evoked potentials) findings indicating demyelinating injury within CNS,
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- biochemical (the positive result of MOG IgG test performed with modern cell-based assay).
4. Disease Course and Epidemiology
5. Neuropathology
6. Neuroimaging
7. MOGAD Diagnosis
8. MOGAD Treatment
9. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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NMO | MS | MOGAD | |
---|---|---|---|
Oligoclonal bands (OCB) | Typically absent (present in approx. 15–30% of NMO patients, they can occur transiently) | Positive in approx. 85–90% of MS patients (they do not disappear or change in the course of the disease or following treatment) | CSF-restricted OCB unusual, positive in a minority of samples (13.2%) |
IgG index | Usually elevated | Elevated > 0.7 (typically > 1.7) in approx. 70% of MS patients (decreases following steroid treatment) | elevated in a minority of samples (8%) |
Total protein | Elevated (100–500 mg/dL) in approx. 25–30% of NMO patients | Within normal limits or > 40 mg/dL in approx. 15% of MS patients | elevated in approx. 44% of samples (range 45.3–176 mg/dL) |
Cytosis | >50/mm3 (at the time of the attack in approx. 30–80% of NMO patients) | >5/mm3 (rarely above 50/mm3) in approx. 30% of patients | Pleocytosis present at least once in> 57% of samples, > 50 cells/mm3 in about 19% of cases |
Cell type | Neutrophil-predominant pleocytosis, with the presence of eosinophils | Mononuclear cells; lymphocyte-predominant | Lymphocytes and monocytes, neutrophils present in at least 43% of cases; eosinophils and basophils–very rare |
Clinical | |
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Optic neuritis (ON) |
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Myelitis |
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ADEM brainstem/cortical encephalitis |
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Fundoscopy |
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Others |
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Laboratory | |
MRI image |
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CSF |
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Histopathology |
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Treatment response |
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Ambrosius, W.; Michalak, S.; Kozubski, W.; Kalinowska, A. Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management. Int. J. Mol. Sci. 2021, 22, 100. https://doi.org/10.3390/ijms22010100
Ambrosius W, Michalak S, Kozubski W, Kalinowska A. Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management. International Journal of Molecular Sciences. 2021; 22(1):100. https://doi.org/10.3390/ijms22010100
Chicago/Turabian StyleAmbrosius, Wojciech, Sławomir Michalak, Wojciech Kozubski, and Alicja Kalinowska. 2021. "Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management" International Journal of Molecular Sciences 22, no. 1: 100. https://doi.org/10.3390/ijms22010100