Additional Recommendations for Testing Myelin Oligodendrocyte Glycoprotein Antibodies

Testing of myelin oligodendrocyte glycoprotein (MOG) antibodies is becoming more common in clinical practice in suspected MOG-associated disease (MOGAD). Antibodies are most frequently tested in serum (NEJM JW Neurol Jan 26 2023 and Neurology 2023; 100:e1095). Investigators in Japan have now evaluated MOG-IgG in paired serum and cerebrospinal fluid (CSF).

Initially, 4785 patients were sent for testing. After ensuring collection before acute treatment, sufficient clinical data, and paired serum and CSF samples, 133 tested positive for MOG by either serum or CSF, 94 (70%) of whom were positive in both, 17 (13%) in serum only, and 22 (17%) in CSF only. Serum MOG was associated with optic neuritis and acute disseminated encephalomyelitis (ADEM),…