{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T02:37:40Z","timestamp":1794364660868,"version":"4.9.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Myelin oligodendrocyte glycoprotein antibody associated disease (MOG-AD) is a CNS demyelinating disease, typically presenting with optic neuritis, transverse myelitis, and\/or ADEM-like syndromes. The positive predictive value (PPV) of MOG-IgG testing by live cell-based assay was reported to be 72% in a study performed at the Mayo Clinic using a cut-off of 1:20. PPV may vary depending upon the tested population, thus supporting further investigation of MOG-IgG testing at other centers. In this real-world institutional cohort study, we determined the PPV of serum MOG-IgG for clinically defined MOG-AD in our patient population. The Massachusetts General Brigham Research Patient Data Registry database was queried for patients with positive serum MOG-IgG detection, at least once, between January 1, 2017 and March 25, 2021. All were tested via the MOG-IgG1 fluorescence-activated cell sorting assay (Mayo Laboratories, Rochester, MN). MOG-IgG positive cases were reviewed for fulfillment of typical MOG-AD clinical features, determined by treating neurologists and study authors. Of 1,877 patients tested, 78 (4.2%) patients tested positive for MOG-IgG with titer \u22651:20, and of these, 67 had validated MOG-AD yielding a PPV of 85.9%. Using a \u22651:40 titer cutoff, 65 (3.5%) tested positive and PPV was 93.8%. Three MOG positive cases had a prototypical multiple sclerosis diagnosis (RRMS <jats:italic>n<\/jats:italic> = 2, titers 1:20 and 1:40; PPMS <jats:italic>n<\/jats:italic> = 1; 1:100). The treating diagnosis for one RRMS patient with a 1:40 titer was subsequently modified to MOG-AD by treating neurologists. Validated diagnoses of the remaining positive patients without MOG-AD included: migraine (<jats:italic>n<\/jats:italic> = 2, titers 1:20, 1:100), inclusion body myositis (<jats:italic>n<\/jats:italic> = 1, titer 1:100), autoimmune encephalitis (<jats:italic>n<\/jats:italic> = 2, titers 1:20, 1:20), hypoxic ischemic brain injury (<jats:italic>n<\/jats:italic> = 1, titer 1:20), IgG4-related disease (<jats:italic>n<\/jats:italic> = 1, titer 1:20), and idiopathic hypertrophic pachymeningitis (<jats:italic>n<\/jats:italic> = 1, titer 1:20). In our cohort, the PPV for MOG-IgG improved utilizing a titer cut-off of \u22651:40. The presence of positive cases with and without demyelinating features, emphasizes a need for testing in the appropriate clinical context, analysis of titer value and clinical interpretation.<\/jats:p>","DOI":"10.3389\/fneur.2022.947630","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T07:12:58Z","timestamp":1655709178000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":27,"title":["Positive Predictive Value of MOG-IgG for Clinically Defined MOG-AD Within a Real-World Cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"Giovanna S.","family":"Manzano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Salky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farrah J.","family":"Mateen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric C.","family":"Klawiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanuja","family":"Chitnis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Matiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e674","DOI":"10.1212\/NXI.0000000000000674","article-title":"International multicenter examination of MOG antibody assays","volume":"7","author":"Reindl","year":"2020","journal-title":"Neurol Neuroimmunol 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Scler."},{"key":"B11","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1001\/jamaneurol.2021.0912","article-title":"Positive predictive value of myelin oligodendrocyte glycoprotein autoantibody testing","volume":"78","author":"Sechi","year":"2021","journal-title":"JAMA Neurol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e1250","DOI":"10.1212\/WNL.0000000000007096","article-title":"A multicenter comparison of MOG-IgG cell-based assays","volume":"92","author":"Waters","year":"2019","journal-title":"Neurology."},{"key":"B13","doi-asserted-by":"publisher","first-page":"103746","DOI":"10.1016\/j.msard.2022.103746","article-title":"Implications of Low-Titer MOG Antibodies","volume":"59","author":"Levy","year":"2022","journal-title":"Mult Scler Relat Disord"},{"key":"B14","doi-asserted-by":"publisher","first-page":"20552173211022770","DOI":"10.1177\/20552173211022767","article-title":"Frequency of myelin oligodendrocyte glycoprotein antibodies in a large cohort of neurological patients","volume":"7","author":"Held","year":"2021","journal-title":"Mult Scler J Exp Transl Clin."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1177\/13524585221093789.","article-title":"Seru MOG-IgG in children meeting multiple sclerosis diagnostic criteria","author":"Fadda","year":"2022","journal-title":"Mult Scler J"}],"container-title":["Frontiers in 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