MOG-IgG1 and co-existence of neuronal autoantibodies
| Autor: | John J. Chen, Revere P. Kinkel, Sean J. Pittock, Justin Dominick, Jonathan D. Santoro, Kurt M. Sieloff, J. Alfredo Caceres, Amy Kunchok, Andrew McKeon, Karl N. Krecke, Miguel Ruvalcaba, Ian Ferguson, John C. Probasco, Jeremy Timothy, Eoin P. Flanagan, Brian G. Weinshenker |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Adolescent Article Immunoglobulin G Myelin oligodendrocyte glycoprotein Young Adult 03 medical and health sciences 0302 clinical medicine immune system diseases Humans Medicine In patient Child Autoantibodies 030304 developmental biology Autoimmune encephalitis 0303 health sciences biology business.industry Multiple sclerosis Autoantibody Syndrome medicine.disease nervous system Neurology Child Preschool Immunology biology.protein Myelin-Oligodendrocyte Glycoprotein Neurology (clinical) Antibody business 030217 neurology & neurosurgery |
| Zdroj: | Mult Scler |
| ISSN: | 1477-0970 1352-4585 |
| Popis: | Background: The presence of co-existent neuronal antibodies (neuronal-IgG) in patients with myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG1) is not yet well understood. Objectives: The aim of this study was to investigate the co-existence of a broad range of neuronal-IgG in MOG-IgG1+ patients. Methods: MOG-IgG1+ patients were tested for 17 neuronal-IgGs in cerebrospinal fluid (CSF) and serum including NMDA-R-IgG, AMPA-R-IgG, GABAB-R-IgG, LGI1-IgG, CASPR2-IgG, GABAA-R-IgG, GAD65-IgG, mGLUR1-IgG, DPPX-IgG, CRMP5-IgG, amphiphysin-IgG, PCA1,2,Tr, and ANNA1,2,3. Clinical and radiological features of MOG-IgG1+ with NMDA-R-IgG in CSF were compared to a control cohort of MOG-IgG1+ patients without NMDA-R-IgG. Results: A total of 376 MOG-IgG1+ patients underwent testing for neuronal-IgGs. Serum testing for neuronal-IgGs (113 adults, 142 children) identified one child with NMDA-R-IgG (0.7%), one child with CASPR2-IgG (0.7%), one adult with LGI1-IgG (0.9%) and one adult with GABAA-R-IgG (0.9%). CSF testing for neuronal-IgGs (97 adults, 169 children) identified seven children (4%) and seven adults (7%) with NMDA-R-IgG, and one adult with GABAA-R-IgG (1%). The MOG-IgG1+/NMDA-R-IgG+ patients had a median age of 17 (range: 2–39) years. Features associated with MOG-IgG1+/NMDA-R-IgG+ included encephalopathy ( p = 0.001), seizures ( p = 0.045), and leptomeningeal enhancement ( p = 0.045). Conclusion: NMDA-R-IgG was the most frequently detected neuronal-IgG to co-exist with MOG-IgG1. MOG-IgG1+/NMDA-R-IgG+ patients most often presented with encephalopathy and seizures. Testing for MOG-IgG1 and NMDA-R-IgG may be warranted in patients with encephalopathy and inflammatory demyelinating syndromes. |
| Databáze: | OpenAIRE |
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