1
|
Manzano GS, Levy M, Salky R, Mateen FJ, Klawiter EC, Chitnis T, Vasileiou ES, Sotirchos ES, Gibbons E, Huda S, Jacob A, Matiello M. Assessment of international MOGAD diagnostic criteria in patients with overlapping MOG-associated disease and multiple sclerosis phenotypes. J Neurol 2024; 271:6160-6171. [PMID: 39066792 DOI: 10.1007/s00415-024-12585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The clinical spectrum and diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has evolved in the setting of an optimized anti-MOG-IgG cell-based assay and expert consensus. The McDonald criteria for MS have been revised multiple times to improve the accuracy and specificity of diagnosis on a framework based on clinical presentation, MRI findings, and CSF results. While the uses of MS and MOGAD diagnostic criteria are helpful for typical cases, such utility for patients with overlapping clinical, laboratorial, and imaging features is unknown, posing diagnostic and management uncertainties. OBJECTIVES To report a multicenter cohort of patients with overlapping phenotypic features of MOGAD and MS and evaluate the application of new MOGAD diagnostic criteria. METHODS A collaborative retrospective cohort study was performed to identify patients with both positive serum anti-MOG-IgG and fulfillment of the MS revised 2017 McDonald criteria. Clinical and radiographic features of patients fulfilling inclusion criteria were reviewed longitudinally, including relapses, repeated MRI, and MOG-IgG testing in detail to allow the panel of expert opinion to assign to each case. The International MOGAD Panel proposed criteria were applied at onset and last follow-up to each case and compared to the expert author diagnosis assignment based on presentation, clinical and imaging features, and response to treatment. RESULTS Ten of 225 (4%) MOG-IgG seropositive cases met study inclusion criteria [seven of 10 were female; age at initial event: eight adults (mean age 26.8 years), two adolescents (mean age 14.5 years)]. AQP4-IgG was negative for all. Apart from serum titers of MOG-IgG, distinguishing clinical and radiographic features [i.e., clinical severity of the initial demyelinating event, radiographic features (optic nerve/spine/brain), and presence/absence of lesion normalization on serial scans] led to consensus of three separate classifications differing by degrees of shared features of MOGAD and MS. Patients were classified by expert panel into (1) Classic MOGAD even with MS-like, well-defined brain lesions, when severe events and most T2 lesions normalized (n = 5; MOG-IgG titers 1:100, 1:20, 1:160, 1:40, 1:200); (2) Classic RRMS included cases thought to have likely false positive or clinically irrelevant MOG-IgG, due to mild clinical events and no radiographic normalization of well-defined MS-like lesions (n = 3; MOG titers 1:20, 1:100, 1:40); (3) MOGAD and MS overlapping phenotype was defined by those with a combination of mild and severe clinical events, partial T2 lesion normalization, both well- and ill-defined lesions (n = 2; MOG titers 1:20, 1:100). The application of the International MOGAD Panel criteria categorized five patients (50%) in agreement with expert assignment. One additional patient was classified in agreement to assignment when MOGAD criteria were applied after serial MOG-IgG titers testing. DISCUSSION While the International MOGAD Panel diagnostic criteria have helped with accuracy for the diagnosis of this condition, in a group of patients seropositive for MOG-IgG with overlapping clinical and imaging features of RRMS criteria review may lead to increased accuracy. Serial serologies, repeated imaging, close attention to clinical course, and response to therapy are possible variables to consider for further refinement of MOGAD diagnostic criteria.
Collapse
Affiliation(s)
- Giovanna S Manzano
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael Levy
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Rebecca Salky
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Farrah J Mateen
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Eric C Klawiter
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Tanuja Chitnis
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Eleni S Vasileiou
- Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Elias S Sotirchos
- Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Saif Huda
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Anu Jacob
- Section of Multiple Sclerosis and Autoimmune Neurology, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Marcelo Matiello
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA.
| |
Collapse
|
2
|
Li Y, Liu X, Wang J, Pan C, Tang Z. Clinical Features and Imaging Findings of Myelin Oligodendrocyte Glycoprotein-IgG-Associated Disorder (MOGAD). Front Aging Neurosci 2022; 14:850743. [PMID: 35370624 PMCID: PMC8965323 DOI: 10.3389/fnagi.2022.850743] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/08/2022] [Indexed: 01/14/2023] Open
Abstract
Myelin oligodendrocyte glycoprotein-IgG-associated disorder (MOGAD) is a nervous system (NS) demyelination disease and a newly recognized distinct disease complicated with various diseases or symptoms; however, MOGAD was once considered a subset of neuromyelitis optica spectrum disorder (NMOSD). The detection of MOG-IgG has been greatly improved by the cell-based assay test method. In one study, 31% of NMOSD patients with negative aquaporin-4 (AQP-4) antibody were MOG-IgG positive. MOGAD occurs in approximately the fourth decade of a person’s life without a markedly female predominance. Usually, optic neuritis (ON), myelitis or acute disseminated encephalomyelitis (ADEM) encephalitis are the typical symptoms of MOGAD. MOG-IgG have been found in patients with peripheral neuropathy, teratoma, COVID-19 pneumonia, etc. Some studies have revealed the presence of brainstem lesions, encephalopathy or cortical encephalitis. Attention should be given to screening patients with atypical symptoms. Compared to NMOSD, MOGAD generally responds well to immunotherapy and has a good functional prognosis. Approximately 44-83% of patients undergo relapsing episodes within 8 months, which mostly involve the optic nerve, and persistently observed MOG-IgG and severe clinical performance may indicate a polyphasic course of illness. Currently, there is a lack of clinical randomized controlled trials on the treatment and prognosis of MOGAD. The purpose of this review is to discuss the clinical manifestations, imaging features, outcomes and prognosis of MOGAD.
Collapse
|
3
|
Eichinger A, Neumaier I, Skerra A. The extracellular region of bovine milk butyrophilin exhibits closer structural similarity to human myelin oligodendrocyte glycoprotein than to immunological BTN family receptors. Biol Chem 2021; 402:1187-1202. [PMID: 34342946 DOI: 10.1515/hsz-2021-0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 06/17/2021] [Indexed: 11/15/2022]
Abstract
Bovine butyrophilin (BTN1A1) is an abundant type I transmembrane glycoprotein exposed on the surface of milk fat globules. We have solved the crystal structure of its extracellular region via multiple wavelength anomalous dispersion after incorporation of selenomethionine into the bacterially produced protein. The butyrophilin ectodomain exhibits two subdomains with immunoglobulin fold, each comprising a β-sandwich with a central disulfide bridge as well as one N-linked glycosylation. The fifth Cys residue at position 193 is unpaired and prone to forming disulfide crosslinks. The apparent lack of a ligand-binding site or receptor activity suggests a function predominantly as hydrophilic coat protein to prevent coagulation of the milk fat droplets. While there is less structural resemblance to members of the human butyrophilin family such as BTN3A, which play a role as immune receptors, the N-terminal bovine butyrophilin subdomain shows surprising similarity to the human myelin oligodendrocyte glycoprotein, a protein exposed on the surface of myelin sheaths. Thus, our study lends structural support to earlier hypotheses of a correlation between the consumption of cow milk and prevalence of neurological autoimmune diseases and may offer guidance for the breeding of cattle strains that express modified butyrophilin showing less immunological cross-reactivity.
Collapse
Affiliation(s)
- Andreas Eichinger
- Lehrstuhl für Biologische Chemie, Technische Universität München, Emil-Erlenmeyer-Forum 5, D-85354 Freising, Germany
| | - Irmgard Neumaier
- Lehrstuhl für Biologische Chemie, Technische Universität München, Emil-Erlenmeyer-Forum 5, D-85354 Freising, Germany
| | - Arne Skerra
- Lehrstuhl für Biologische Chemie, Technische Universität München, Emil-Erlenmeyer-Forum 5, D-85354 Freising, Germany
| |
Collapse
|
4
|
Zheng Y, Cai MT, Li EC, Fang W, Shen CH, Zhang YX. Case Report: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder Masquerading as Multiple Sclerosis: An Under-Recognized Entity? Front Immunol 2021; 12:671425. [PMID: 34220818 PMCID: PMC8249196 DOI: 10.3389/fimmu.2021.671425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) covers a wide spectrum of manifestations and is defined by the presence of MOG seropositivity. However, in a proportion of patients, there may be an overlap in some of the clinical and radiological manifestations between MOGAD and multiple sclerosis (MS). Being wary of this entity is critical to ensure appropriate therapy. Herein, we present a case with recurrent episodes of short-segment myelitis typical for multiple sclerosis, but later diagnosed as MOGAD by MOG antibody seropositivity. This case, along with previous reports, highlights an increasingly recognized subgroup in MOGAD with initial clinical phenotypes suggestive of MS, but later showing a disease course and therapeutic response compatible with MOGAD. Given the potential overlap of some clinical phenotypes in patients with MS and those with MOGAD, we recommend MOG antibody testing in all patients with recurrent short-segment myelitis, conus medullaris involvement, and those who demonstrated steroid dependence.
Collapse
Affiliation(s)
- Yang Zheng
- Department of Neurology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China
| | - Meng-Ting Cai
- Department of Neurology, Second Affiliated Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Er-Chuang Li
- Department of Neurology, Second Affiliated Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Wei Fang
- Department of Neurology, Fourth Affiliated Hospital School of Medicine Zhejiang University, Yiwu, China
| | - Chun-Hong Shen
- Department of Neurology, Second Affiliated Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Yin-Xi Zhang
- Department of Neurology, Second Affiliated Hospital School of Medicine Zhejiang University, Hangzhou, China
| |
Collapse
|
5
|
Clinical characteristics of MOG antibody disease: two case reports. Neurol Sci 2021; 42:2979-2985. [PMID: 33569706 PMCID: PMC8263453 DOI: 10.1007/s10072-021-05122-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
|
6
|
Otto F, Moser T, Feige J, Seiberl M, Bieler L, Sellner J. Successful disease control with alemtuzumab in MOG-IgG-associated demyelinating disease with MS-phenotype. Mult Scler Relat Disord 2020; 42:102108. [PMID: 32339987 DOI: 10.1016/j.msard.2020.102108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 01/25/2023]
Abstract
Immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein in serum denote an emerging autoimmune disorder of the central nervous system. Treatment trials have not been performed so far and anecdotal reports suggest that immunotherapies approved for multiple sclerosis (MS) may not be effective. We report favorable disease control with alemtuzumab, a CD52 depleting antibody approved for active MS, in a 34-year-old woman with the rarer condition of MOG-IgG disease with MS-phenotype. MOG-IgG in serum persisted over the entire observation period of almost five years. This case emphasizes that treatment responses may be distinct for different phenotypes of MOG-IgG associated disease.
Collapse
Affiliation(s)
- Ferdinand Otto
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020.
| | - Tobias Moser
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020.
| | - Julia Feige
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020.
| | - Michael Seiberl
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020
| | - Lara Bieler
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020; Department of Neurology, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany; Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria.
| |
Collapse
|
7
|
Atypical MOG antibody disease presenting with typical multiple sclerosis lesions. Mult Scler Relat Disord 2020; 44:102342. [PMID: 32615531 DOI: 10.1016/j.msard.2020.102342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 11/21/2022]
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody disease is an autoimmune disease of the central nervous system associated with a serological antibody against MOG, a glycoprotein expressed on the outer membrane of myelin. It is solely found within the central nervous system in the brain, optic nerves and spinal cord. MOG antibody disease falls within the neuromyelitis optica spectrum disorders (NMOSD), however clinical characteristics appear distinct from aquaporin-4 antibody related disease and multiple sclerosis. It has predilection for causing recurrent optic neuritis and transverse myelitis. Accurate diagnosis is important to determine long term prognosis and suitable treatment. We describe the case of a 42 year old woman previously labelled as MS who demonstrated a variable presentation of MOG antibody disease.
Collapse
|
8
|
Tzartos JS, Karagiorgou K, Tzanetakos D, Breza M, Evangelopoulos ME, Pelidou SH, Bakirtzis C, Nikolaidis I, Koutsis G, Notas K, Chroni E, Markakis I, Grigoriadis NC, Anagnostouli M, Orologas A, Parisis D, Karapanayiotides T, Papadimitriou D, Kostadima V, Elloul J, Xidakis I, Maris T, Zisimopoulou P, Tzartos S, Kilidireas C. Deciphering anti-MOG IgG antibodies: Clinical and radiological spectrum, and comparison of antibody detection assays. J Neurol Sci 2020; 410:116673. [PMID: 31954354 DOI: 10.1016/j.jns.2020.116673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/17/2019] [Accepted: 01/03/2020] [Indexed: 02/08/2023]
Abstract
IgG antibodies to myelin oligodendrocyte glycoprotein (MOG) detected by cell based assays (CBA) have been identified in a constantly expanding spectrum of CNS demyelinating disorders. However, a universally accepted CBA has not been adopted yet. We aimed to analyze the clinical and radiological features of patients with anti-MOG IgG1-antibodies detected with a live-cell CBA and to compare the three most popular MOG-CBAs. We screened sera from 1300 Greek patients (including 426 patients referred by our 8 clinics) suspected for anti-MOG syndrome, and 120 controls with the live-cell MOG-CBA for IgG1-antibodies. 41 patients, versus 0 controls were seropositive. Clinical, serological and radiological data were available and analyzed for the 21 seropositive patients out of the 426 patients of our clinics. Their phenotypes were: 8 optic neuritis, 3 myelitis, 3 neuromyelitis optica, 2 encephalomyelitis, 2 autoimmune encephalitis and 3 atypical MS. We then retested all sera of our 426 patients with the other two most popular MOG-CBAs for total IgG (a live-cell and a commercial fixed-cell CBAs). Seven IgG1-seropositive patients were seronegative for one or both IgG-CBAs. Yet, all 21 patients had clinical and radiological findings previously described in MOG-antibody associated demyelination disease supporting the high specificity of the IgG1-CBA. In addition, all IgG1-CBA-negative sera were also negative by the IgG-CBAs. Also, all controls were negative by all three assays, except one serum found positive by the live IgG-CBA. Overall, our findings support the wide spectrum of anti-MOG associated demyelinating disorders and the superiority of the MOG-IgG1 CBA over other MOG-CBAs.
Collapse
Affiliation(s)
- John S Tzartos
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece; Tzartos NeuroDiagnostics, 3, Eslin str., Athens 11523, Greece.
| | - Katerina Karagiorgou
- Tzartos NeuroDiagnostics, 3, Eslin str., Athens 11523, Greece; Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece
| | - Dimitrios Tzanetakos
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece
| | - Marianthi Breza
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece
| | - Maria Eleftheria Evangelopoulos
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece
| | | | - Christos Bakirtzis
- 2nd Neurology Department, University Hospital of Thessaloniki "AHEPA", Thessaloniki, Greece
| | - Ioannis Nikolaidis
- 2nd Neurology Department, University Hospital of Thessaloniki "AHEPA", Thessaloniki, Greece
| | - Georgios Koutsis
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece
| | | | - Elisabeth Chroni
- Neurology Department, University Hospital of Patras, Rίo 265 04, Greece
| | - Ioannis Markakis
- Neurology Department, General Hospital of Nikaia, 3, Andrea Petrou Mandouvalou, Athens 184 54, Greece
| | - Nikolaos C Grigoriadis
- 2nd Neurology Department, University Hospital of Thessaloniki "AHEPA", Thessaloniki, Greece
| | - Maria Anagnostouli
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece
| | | | - Dimitrios Parisis
- 2nd Neurology Department, University Hospital of Thessaloniki "AHEPA", Thessaloniki, Greece
| | | | | | | | - John Elloul
- Neurology Department, University Hospital of Patras, Rίo 265 04, Greece
| | - Iosif Xidakis
- Neurology Department, General Hospital of Nikaia, 3, Andrea Petrou Mandouvalou, Athens 184 54, Greece
| | - Thomas Maris
- Neurology Clinic, Venizeleio General Hospital, Knossos Ave, Heraklion 714 09, Greece
| | - Paraskevi Zisimopoulou
- Lab. of Molecular Neurobiology and Immunology, Hellenic Pasteur Institute, 127, Vas. Sofias Ave., Athens 11521, Greece
| | - Socrates Tzartos
- Tzartos NeuroDiagnostics, 3, Eslin str., Athens 11523, Greece; Lab. of Molecular Neurobiology and Immunology, Hellenic Pasteur Institute, 127, Vas. Sofias Ave., Athens 11521, Greece
| | - Costas Kilidireas
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72-74, Vas. Sofias Ave, Athens 11528, Greece
| |
Collapse
|
9
|
Brayo P, Hartsell FL, Skeen M, Morgenlander J, Eckstein C, Shah S. The clinical presentation and treatment of MOG antibody disease at a single academic center: A case series. J Neuroimmunol 2019; 337:577078. [DOI: 10.1016/j.jneuroim.2019.577078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/24/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
|
10
|
Breza M, Koutsis G, Tzartos JS, Velonakis G, Evangelopoulos ME, Tzanetakos D, Karagiorgou K, Angelopoulou G, Kasselimis D, Potagas C, Anagnostouli M, Stefanis L, Kilidireas C. Response to correspondence: Testing for myelin oligodendrocyte glycoprotein antibody (MOG-IgG) in typical MS. Mult Scler Relat Disord 2019; 35:156-157. [PMID: 31376687 DOI: 10.1016/j.msard.2019.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Marianthi Breza
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece.
| | - Georgios Koutsis
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece
| | - John S Tzartos
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece; Tzartos Neurodiagnostics, Athens, Greece
| | - Georgios Velonakis
- 2nd Department of Radiology, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Eleftheria Evangelopoulos
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece
| | - Dimitrios Tzanetakos
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece
| | | | - Georgia Angelopoulou
- Neuropsychology and Speech Pathology Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Speech Pathology Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Crete, Greece
| | - Constantin Potagas
- Neuropsychology and Speech Pathology Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece
| | - Leonidas Stefanis
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece
| | - Constantinos Kilidireas
- Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 72-74, 11528 Athens, Greece
| |
Collapse
|
11
|
Lopez-Chiriboga S, Pittock SJ, Weinshenker BG, Chen JJ, Flanagan E. Testing for Myelin Oligodendrocyte Glycoprotein Antibody (MOG-IgG) in typical MS. Mult Scler Relat Disord 2019; 35:34-35. [PMID: 31299419 DOI: 10.1016/j.msard.2019.06.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 12/01/2022]
Affiliation(s)
| | - Sean J Pittock
- Department of Neurology, 200 1st St SW, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | | | - John J Chen
- Department of Neurology, 200 1st St SW, Rochester, MN 55905, USA; Department of Ophthalmology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Eoin Flanagan
- Department of Neurology, 200 1st St SW, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| |
Collapse
|