Clinical Characteristics of Multiple Sclerosis Patients with Seropositive MOG Antibody Test
Amara Plaza-Jennings1, Phillippe Bilodeau1, Anastasia Vishnevetsky2, Michael Levy3, Jodie Burton4
1Mass General Brigham, 2Massachusetts General Hospital, 3Massachusetts General Hospital/Harvard Medical School, 4University of Calgary
Objective:
To determine if multiple sclerosis (MS) patients who test positive for the myelin oligodendrocyte glycoprotein (MOG) antibody test have different disease characteristics than typically seen in MS.
Background:
MS and MOG associated-antibody disease (MOGAD) are distinct CNS demyelinating disorders with different courses and treatments but can be difficult to distinguish from each other. Some patients who meet McDonald criteria for MS also have MOG antibodies, the significance of which is unknown.
Design/Methods:
Patients at Mass General Brigham with MOG IgG1 antibodies in serum by cell-based assay (n=295) who did not meet criteria for a diagnosis of MOGAD (n=59) underwent chart review to extract patients who met current McDonald diagnostic criteria for MS as determined by a consensus of 3 MS neurologists. Ten such patients were identified.
Results:
Of these 10 patients, 70% (n=7) were female and had a mean age at onset of 27.4 years (SD=10.5). All had MOG IgG1 titers of ≤1:20 except one with a titer of 1:100. Of the 5 patients with repeat antibody testing, only one sero-reverted. Phenotypically, one had perineural optic nerve enhancement while another had a longitudinally extensive optic nerve lesion on MRI. Six of ten patients developed new MRI lesions while on high efficacy MS therapies for ≥6 months.
Conclusions:
We studied the course of 10 patients who met criteria for MS who had positive MOG antibodies. Overall, clinical, radiological, and serum and CSF biomarker findings conformed to expectations for MS patients. However, some radiological features of optic neuritis more consistent with MOGAD were seen, and interestingly, 60% had MRI lesion accrual on high-efficacy MS therapy, much greater than would be expected. Our findings raise the hypothesis that the presence of MOG antibodies in MS impacts disease course. A larger prospective study is needed to confirm our findings.
Generative AI Usage
No, did not use generative AI in the drafting or editing in this abstract.
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