南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (11): 1865-1873.doi: 10.12122/j.issn.1673-4254.2023.11.05

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不同滴度MOG-IgG抗体在MOG抗体相关疾病中的诊断和临床意义：一项单中心回顾性研究

李子昂，王冬梅，陈金玉，黄小珍，吴永明，胡亚芳   

  1. 南方医科大学南方医院神经内科，广东 广州 510515
  • 出版日期:2023-11-20 发布日期:2023-12-08

Diagnostic value of low versus high titers of MOG-IgG and their clinical implications in myelin oligodendrocyte glycoprotein antibody-associated disease: a retrospective single-center study

LI Ziang, WANG Dongmei, CHEN Jinyu , HUANG Xiaozhen, WU Yongming , HU Yafang   

  1. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Online:2023-11-20 Published:2023-12-08

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摘要： 目的 总结本中心外周血髓鞘少突胶质细胞糖蛋白（MOG）抗体阳性患者的临床特征，探讨不同滴度抗体对诊断的意义。方法 对2020年12月~2022年12月入院的血清MOG抗体阳性患者进行了回顾性研究。收集患者的一般人口学特征、实验室检查结果、影像学特点、治疗及预后信息。以1∶100作为分界值将患者分为高、低两个滴度组，对两组患者的特征进行对比分析。结果 共纳入36例患者，其中28例被诊断为MOGAD（77.78%，低滴度15例，高滴度13例）。MOGAD的临床特征与既往研究报道基本一致，临床表现略有不同，感觉异常发生率较高（52.78%），视力丧失的比例较低（25%）。磁共振成像结果显示脑室周围白质为常见病变部位（45.71%）。高滴度组患者血清淋巴细胞水平明显降低（P=0.025），中性粒细胞与淋巴细胞比值（NLR）较高（P=0.045），血清游离甲状腺素（FT4）水平较高（P=0.033），脑脊液中葡萄糖水平较高（P=0.007）。结论 低滴度和高滴度的MOG-IgG在MOGAD的诊断价值上相似，且不同滴度结果可能与疾病严重程度和应激水平有关。

关键词: 少突胶质细胞糖蛋白；核磁共振；脱髓鞘疾病

Abstract: Objective To summarize the clinical characteristics of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and explore the value of MOG-IgG titers for diagnosis and evaluating disease severity of MOGAD. Methods This retrospective study was conducted among the patients positive for serum MOG- IgG admitted in our hospital from December, 2020 to December, 2022. With 1∶100 as the cutoff value of MOG-IgG titer, the patients were divided into low and high MOG- IgG titer groups for comparison of general demographic data, laboratory test results, imaging features, treatment, and prognosis. Results Of the 36 patients included, 28 were diagnosed with MOGAD (77.78% ), including 15 with low and 13 with high MOG- IgG titers. Compared with the cases reported previously, the MOGAD patients included herein showed a higher prevalence of sensory abnormalities (52.78%) and a lower prevalence of vision loss (25%). Magnetic resonance imaging showed that the periventricular white matter was the most common lesion site (45.71%). The patients with high MOG-IgG titers had significantly lower peripheral blood lymphocyte counts (P=0.025) with an increased neutrophil- to-lymphocyte ratio (P=0.045), higher serum free thyroxine levels (P=0.033) and higher cerebrospinal fluid glucose levels (P=0.007) as compared with those with low MOG- IgG titers. Conclusion Low titers and high titers of MOG- IgG have similar diagnostic value for MOGAD. The serum titers of MOG- IgG are probably associated with the disease severity and stress levels of the patients with MOGAD.

Key words: myelin oligodendrocyte glycoprotein; magnetic resonance imaging; demyelinating disease