title: Antibodies to myelin oligodendrocyte glycoprotein in aquaporin 4 antibody seronegative longitudinally extensive transverse myelitis: Clinical and prognostic implications.
abstract: OBJECTIVE
  We aimed to investigate the frequency and clinical significance of antibodies to myelin oligodendrocyte glycoprotein (MOG-abs) in patients who presented with a first episode of seronegative aquaporin 4 antibody (AQP4-ab) longitudinally extensive transverse myelitis (LETM).
  
  
  METHODS
  Epidemiological, clinical, and paraclinical data of 56 patients from three European centres were analysed. Patients were retrospectively tested for MOG-abs and AQP4-abs, by cell-based assays.
  
  
  RESULTS
  Thirteen (23.2%) patients were MOG-ab positive. Among the 56 patients, six (10.7%) converted to neuromyelitis optica (NMO), one (1.8%) to multiple sclerosis (MS), nine (16.1%) had recurrent LETM, and 40 (71.4%) remained as monophasic LETM. Compared with seronegative patients, those with MOG-abs were younger (median: 32.5 vs 44 years; p=0.007), had cerebrospinal fluid pleocytosis more frequently (94% vs 45%, p=0.003) and had better outcome (median Expanded Disability Status Scale (EDSS) 2.0 vs 3.0, p=0.027). MOG-ab positive patients also showed an increase risk of optic neuritis relapse and NMO conversion (p=0.010).
  
  
  CONCLUSIONS
  Patients with MOG-abs in AQP4-ab seronegative LETM have clinical distinctive features, higher risk of optic neuritis relapses, and better outcome than patients seronegative.
authors.affiliation: Multiple Sclerosis Unit, Hospital Universitari de Bellvitge, Spain acobo@bellvitgehospital.cat.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Cobo-Calvo
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Sepúlveda
authors.affiliation: Neurology Department, CHU Toulouse, France/Center for Pathophysiology of Toulouse Purpan, INSERM U1028/CNRS 5282, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Bernard-Valnet
authors.affiliation: Lyon Neuroscience Research Center, INSERM U1028/CNRS 5292, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Ruiz
authors.affiliation: Neurology Department, CHU Toulouse, France/Center for Pathophysiology of Toulouse Purpan, INSERM U1028/CNRS 5282, France.
authors.forename: David
authors.initials: D
authors.lastname: Brassat
authors.affiliation: Multiple Sclerosis Unit, Hospital Universitari de Bellvitge, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Martínez-Yélamos
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Saiz
authors.affiliation: Lyon Neuroscience Research Center, INSERM U1028/CNRS 5292, France/Service de Neurologie A, Hôpital Neurologique Pierre Wertheimer, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Marignier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051401:Aquaporin 4 / Q000134:cerebrospinal fluid / Q000276:immunology; D001323:Autoantibodies / Q000134:cerebrospinal fluid / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000276:immunology*; D009188:Myelitis, Transverse / Q000150:complications / Q000276:immunology* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D001324:Autoantigens; D063308:Myelin-Oligodendrocyte Glycoprotein
keywords: Longitudinally extensive transverse myelitis; aquaporin-4 antibody; multiple sclerosis; myelin oligodendrocyte glycoprotein; neuromyelitis optica