RT杂志文章SR电子T1脊髓鞘少突胶质细胞糖蛋白抗体在脑脊液中的意义JF神经学JO神经学FD Lippincott Williams & Wilkins SP e1095 OP e1108 DO 10.1212/WNL半岛投注体育官网.0000000000201662签证官100年11 A1莎拉的法令A1 Alvaro Cobo卡尔沃A1泰国Armangue A1艾伯特Saiz A1基督教莱希A1凯文Rostasy A1马库斯Breu A1马提亚鲍曼A1和平Hoftberger A1 Ilya Ayzenberg A1卡罗琳Schwake A1玛丽亚赛普维达A1 Eugenia马丁斯A1吉玛Olive-Cirera A1乔治娜Arrambide A1 Mar Tintore A1拉斐尔Bernard-Valnet A1 Renaud Du Pasquier A1 Fabienne Brilot A1 Sudarshini拉马纳坦A1凯瑟琳Schanda A1 Alberto Gajofatto A1塞尔吉奥·法拉利A1伊利亚Sechi A1 Eoin P。Flanagan A1 Sean J. Pittock A1 Vyanka Redenbaugh A1 Markus Reindl A1 Romain Marignier A1 Sara Mariotto YR 2023 UL http://n.半岛投注体育官网neurology.org/content/100/11/e1095.abstract AB背景和目的尽管髓磷脂少突胶质细胞糖蛋白抗体相关疾病(MOGAD)的诊断是基于血清MOG抗体(MOG- abs)阳性，但CSF中共存或限制性MOG- abs的患者已被报道。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

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