Systematic Review of Literature of MOG Antibody Positive Patients with Probable Diagnosis of MS
Objective:
To describe the neurological manifestations, imaging findings, presence of MOG antibodies, titers, relapses, and treatments of MOG antibody positive patients mimicking MS or had diagnosis of MS.
Background:
Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is defined as an autoimmune disease of the CNS associated with a serological antibody against myelin oligodendrocyte glycoprotein (MOG). MOG which is found in the optic nerves, brain, and spinal cord. The disease can resemble multiple sclerosis (MS) noted by relapses of optic neuritis and transverse myelitis.
Design/Methods:
We performed a systematic review of literature of case reports or case series of MOG antibody positive patients mimicking MS or had diagnosis of MS. The search was conducted in PubMed from January 1, 2015 through September 20, 2022. The study is registered in PROSPERO registry.
Results:
We found nine patients, who were MOG antibody positive and met the inclusion criteria. All patients met criteria for further MOG antibody testing. Three patients had diagnosis of MOGAD. Most patients were females and paresthesia was the most common presenting symptom. All patients had brain and spinal cord lesions. Of the spinal cord lesions, all had cervical lesions, 44% had thoracic lesions, and 22% had lumbar lesions. C2-C3 was the most commonly affected region. Conus medullaris was present in 33% of patients and none had cauda equina. All patients had white matter lesions, 66% of the lesions were infratentorial, 22% had lesions documented as ovoid and ring-like enhancements. The range of MOG antibody titer is 1:32 – 1:640. All patients experienced a relapse in symptoms during their disease course. Treatments included steroids, disease modifying therapies, azathioprine, and plasma plasmapheresis.
Conclusions:
This study highlights the importance of checking MOG antibody in patients with atypical presentation of MS and interpreting results carefully in patients who have clinical and radiological features similar to MS.