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This study assessed the frequency of seroconversion in a retrospective Cleveland Clinic cohort (2006\u20132024) of 451 patients with an initial negative AQP4\u2010IgG result who underwent serial testing. Seroconversion occurred in 4.3% (7\/170) of patients initially tested by tissue IFA, but in none (0\/263) of those tested by CBA. The lack of AQP4\u2010IgG seroconversion after a negative CBA, with only rare cases after a negative IFA,\u00a0suggests that repeat AQP4\u2010IgG testing\u00a0is low yield unless\u00a0prior testing used older methods such as IFA.<\/jats:p>","DOI":"10.1002\/acn3.70185","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T08:54:16Z","timestamp":1758099256000},"page":"2158-2163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Frequency of Seroconversion in Aquaporin\u20104 Antibody Testing: Insights From Real\u2010World Data"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-2575","authenticated-orcid":false,"given":"Tatchaporn","family":"Ongphichetmetha","sequence":"first","affiliation":[{"name":"Neurology Cleveland Clinic Neurological Institute, Mellen Center for Multiple Sclerosis  Cleveland Ohio USA"},{"name":"Siriraj Neuroimmunology Center 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