TY - JOUR T1 -脊髓鞘少突胶质细胞糖蛋白抗体在脑脊液中的意义JF -神经JO -神经SP - e1095 LP - e1108 DO - 10.1212/WNL.000半岛投注体育官网0000000201662六世- 100 - 11 Cobo卡尔沃盟盟-萨拉的法令盟阿尔瓦罗·艾伯特-泰国人Armangue盟Saiz AU -基督教莱希AU -凯文Rostasy AU -马库斯Breu AU -马蒂亚斯•鲍曼盟和平Hoftberger AU - Ilya Ayzenberg盟卡罗琳Schwake AU -玛丽亚赛盟Eugenia马丁斯盟-吉玛Olive-Cirera AU -乔治娜Arrambide盟- Mar Tintore盟-拉斐尔Bernard-Valnet AU - Renaud Du Pasquier盟Fabienne Brilot盟Sudarshini拉马纳坦盟Alberto Gajofatto——凯瑟琳Schanda盟AU -塞尔吉奥·法拉利盟伊利亚Sechi AU - Eoin p·弗拉纳根AU -肖恩·j·Pittock盟Vyanka Redenbaugh AU -马库斯Reindl盟Romain Marignier AU -萨拉Mariotto Y1 - 2023/03/14 UR - //www.ebmtp.com/content/100/11/e1095.abstract半岛投注体育官网 N2 -背景和目标虽然髓少突细胞糖蛋白antibody-associated疾病的诊断(MOGAD)是基于血清MOG抗体(MOG-Abs)积极性,患者共存或限制MOG-Abs CSF已报告。本研究的目的是描述CSF MOG-Abs阳性在临床实践中的相关性。方法回顾性收集11个医疗中心疑似炎症性中枢神经系统疾病的成人和儿童患者的临床和实验室资料，并采用活细胞法检测血清和/或脑脊液中MOG-Abs阳性。根据需要，使用参数或非参数检验进行比较。采用Cox比例风险模型和logistic回归分析探讨不良预后的潜在因素。该队列包括255例患者:139例(55%)女性和132例(52%)儿童(即18岁)。其中血清和脑脊液均有MOG-Abs (MOG-Abs阳性和脑脊液阳性)145例(56.8%)，仅血清有MOG-Abs (MOG-Abs阳性和脑脊液阴性)79例(31%)，仅脑脊液有MOG-Abs (MOG-Abs阴性和脑脊液阳性)31例(12%)。MOG-Abs血清和CSF阳性以成人(22% vs 3%)为主，更常见的表现为运动症状(n = 14,45%)和感觉症状(n = 13,42%)，除4例(2例多发性硬化症，1例多发性神经根炎和1例Susac综合征)外，最终诊断均与MOGAD相符。当根据MOG-Abs血清阳性患者的CSF状态进行比较时，MOG-Abs血清阳性和CSF阳性患者在指数事件期间具有更高的扩展残疾状态量表(EDSS)(中位数4.5，四分位范围[IQR] 3.0 - 7.5 vs 3.0, IQR 2.0-6.8, p = 0.007)，并且比MOG-Abs血清阳性和CSF阴性患者更常见的表现为感觉症状(45.5% vs 24%， p = 0.002)，运动症状(33.6% vs 19%， p = 0.021)和括约肌症状(26.9% vs 7.8%， p = 0.001)。 At the last follow-up, MOG-Abs seropositive and CSF positive cases had more often persistent sphincter dysfunction (17.3% vs 4.3%, p = 0.008). Compared with seropositive patients, those MOG-Abs seronegative and CSF positive had higher disability at the last follow-up (p ≤ 0.001), and MOG-Abs seronegative and CSF positive status were independently associated with an EDSS ≥3.0.Discussion Paired serum and CSF MOG-Abs positivity are common in MOGAD and are associated with a more severe clinical presentation. CSF-only MOG-Abs positivity can occur in patients with a phenotype suggestive of MOGAD and is associated with a worse outcome. Taken together, these data suggest a clinical interest in assessing CSF MOG-Abs in patients with a phenotype suggestive of MOGAD, regardless of the MOG-Abs serostatus.Abs=antibodies; ADEM=acute disseminated encephalomyelitis; ARR=annualized relapse rate; CBA=cell-based assays; CNS=central nervous system; CI=confidence interval; DMD=disease-modifying drug; EDSS=Expanded Disability Status Scale; IF=immunofluorescence; IQR=interquartile range; MOG=myelin oligodendrocyte glycoprotein; MOG-Abs=MOG antibodies; MOGAD=myelin oligodendrocyte glycoprotein antibody associated disease; MS=multiple sclerosis; NMOSD=neuromyelitis optica spectrum disorder; OR=odds ratio ER -