Jarius, S.Paul, F.Aktas, OrhanAsgari, NasrinDale, Russell C.Seze, J. deFranciotta, DiegoFujihara, KazuoJacob, AnuKim, H. J.Kleiter, IngoKümpfel, TaniaLevy, MichaelPalace, JacquelineRuprecht, KlemensSaiz Hinarejos, AlbertTrebst, CorinnaWeinshenker, Brian G.Wildemann, Brigitte2019-05-202019-05-202018-05-031742-2094https://hdl.handle.net/2445/133483Over the past few years, new-generation cell-based assays have demonstrated a robust association of autoantibodies to full-length human myelin oligodendrocyte glycoprotein (MOG-IgG) with (mostly recurrent) optic neuritis, myelitis and brainstem encephalitis, as well as with acute disseminated encephalomyelitis (ADEM)-like presentations. Most experts now consider MOG-IgG-associated encephalomyelitis (MOG-EM) a disease entity in its own right, immunopathogenetically distinct from both classic multiple sclerosis (MS) and aquaporin-4 (AQP4)-IgG-positive neuromyelitis optica spectrum disorders (NMOSD). Owing to a substantial overlap in clinicoradiological presentation, MOG-EM was often unwittingly misdiagnosed as MS in the past. Accordingly, increasing numbers of patients with suspected or established MS are currently being tested for MOG-IgG. However, screening of large unselected cohorts for rare biomarkers can significantly reduce the positive predictive value of a test. To lessen the hazard of overdiagnosing MOG-EM, which may lead to inappropriate treatment, more selective criteria for MOG-IgG testing are urgently needed. In this paper, we propose indications for MOG-IgG testing based on expert consensus. In addition, we give a list of conditions atypical for MOG-EM ('red flags') that should prompt physicians to challenge a positive MOG-IgG test result. Finally, we provide recommendations regarding assay methodology, specimen sampling and data interpretation.10 p.application/pdfengcc-by (c) Jarius, S. et al., 2018http://creativecommons.org/licenses/by/3.0/esDiagnòsticEsclerosi múltipleMielitisMalalties del sistema nerviós centralDiagnosisMultiple sclerosisMyelitisCentral nervous system diseasesinfo:eu-repo/semantics/article6827032019-05-20info:eu-repo/semantics/openAccess29724224