基于 2023 年 MOGAD 诊断标准的 MOG-IgG 检测的阳性预测值。

IF 2.5 Q2 CLINICAL NEUROLOGY Multiple Sclerosis Journal - Experimental, Translational and Clinical Pub Date : 2024-08-14 eCollection Date: 2024-07-01 DOI:10.1177/20552173241274610
Linda Nguyen, Sumit Singh, Fabricio S Feltrin, Lauren M Tardo, Rebekah L Clarke, Cynthia X Wang, Benjamin M Greenberg
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引用次数: 0

摘要

背景:髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)是脱髓鞘疾病领域中一种相对较新的疾病实体。其首个诊断标准已于近期公布:我们评估了 MOG-IgG 检测的阳性预测值 (PPV),并根据最近公布的标准报告了临床和放射学特征:德克萨斯州达拉斯市的三个中心开展了一项回顾性研究。方法:德克萨斯州达拉斯市的三家中心开展了一项回顾性研究,纳入了在任何时间通过细胞检测获得 MOG-IgG 阳性的患者。阳性病例至少由两名神经免疫学家进行复查,以确定是否符合标准:我们共纳入了 235 名患者。任何时候血清阳性的PPV总体为78.3%,低滴度为52.6%,高滴度为90.1%。儿童的 PPV 值高于成人(93.9% 对 67.2%)。在没有核心脱髓鞘临床发作的患者中,阳性预测值为 6.3%。与成人相比,儿童更常具有视神经炎 MOGAD 的典型影像学特征:我们报告了使用 2023 年 MOGAD 诊断标准进行 MOG-IgG 检测的 PPV 为 78.3%。儿童的 PPV 值更高,支持影像学特征的频率也更高。在对无核心脱髓鞘事件且滴度较低的患者进行 MOGAD 诊断时,有必要慎重考虑。
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The positive predictive value of MOG-IgG testing based on the 2023 diagnostic criteria for MOGAD.

Background: Myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) is a relatively new disease entity in the field of demyelinating disorders. Its first diagnostic criteria have recently been published.

Objectives: We evaluated the positive predictive value (PPV) for MOG-IgG testing and report the clinical and radiologic features with respect to the recently published criteria.

Methods: A retrospective study was conducted at three centers in Dallas, Texas. Patients with positive MOG-IgG testing on cell-based assays at any time were included. Positive cases were reviewed by at least two neuroimmunologists for fulfillment of the criteria.

Results: We included 235 patients. The PPV of seropositivity at any time was 78.3% overall, 52.6% for low titer, and 90.1% for high titer. Children had a higher PPV than adults (93.9% versus 67.2%). Positive predictive value was 6.3% in those without a core clinical demyelinating attack. Children more often have the typical imaging features of MOGAD in optic neuritis than adults.

Conclusions: We report a PPV of 78.3% for MOG-IgG testing using the 2023 MOGAD diagnostic criteria. Children had higher PPV and frequency of supporting imaging features. Careful consideration is necessary when assigning patients with no core demyelinating event and low titers a MOGAD diagnosis.

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来源期刊
CiteScore
4.70
自引率
0.00%
发文量
54
审稿时长
15 weeks
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