Abstract Details

Title Application of NMOSD IPND-2015 Criteria in AQP4-IgG Positive, MOG-IgG Positive and Seronegative Inflammatory Demyelinating Diseases

Topic Autoimmune Neurology

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-004

Objective To evaluate the frequency of cases fulfilling IPND-2015 in a group of AQP4-IgG, MOG-IgG and seronegative patients with inflammatory demyelinating central nervous system disorders

Background The International Panel for Neuromyelitis Optica Diagnosis (IPND-2015) criteria improved early recognition of neuromyelitis optica spectrum disorder (NMOSD). The publication of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) criteria in 2023 underscores the need for validation of these criteria in different populations not only to verify diagnostic yield but also to identify overlaps and areas for improvement.

Design/Methods We performed a cross-sectional study conducted at the Neuroimmunology Clinic of the University of São Paulo. We randomly selected from our records 40 AQP4+, 40 MOG+, and 40 seronegative patients with demyelinating events suspected for NMOSD. All seronegative patients had been tested for both MOG-IgG and AQP4-IgG serum antibodies using cell-based assays. Patients with multiple sclerosis were excluded.

Results All 40 AQP4-IgG+ cases fulfilled IPND-2015, in contrast to 12.5% of MOG-IgG+ and 42.5% of seronegative patients. Demographics were similar across the three groups, except for female proportion (87.5%, 65%, 62.5%) ; AQP4-IgG+, MOG-IgG+ and seronegative patients respectively. Bilateral optic neuritis (35%, 57.5%, 30%), all-time myelitis (85%, 50%, 72.5%), longitudinally extensive transverse myelitis (LETM) (70%, 17.5%, 47.5%), and area postrema syndromes (17.5%, 0%, 20%) had significantly different frequencies between AQP4-IgG, MOG-IgG+ and seronegative patients. The frequency of relapsing course (87.5%, 70%, 55%) was higher in AQP4-IgG+ and MOG-IgG+ when compared to seronegative patients.

Conclusions IPND-2015 criteria were fulfilled in some MOG-IgG+ and almost half of seronegative patients. This finding highlights the need for IPND-2015 criteria refinement regarding the classification of seronegative patients and overlap of both MOGAD-2023 and IPND-2015. Of note, MOGAD cases are now a distinct entity, so use IPND-2015 for these cases may be misleading. Future reviews of IPND-2015 NMOSD diagnostic criteria will require special attention to include seronegative cases.

Authors/Disclosures
Samira Apostolos-Pereira (Hospital Das Clinicas College of Medicine Sao Paulo University) PRESENTER	Samira Apostolos-Pereira has nothing to disclose.
Joao Vitor Mahler, MD	Dr. Mahler has received research support from The Sumaira Foundation.
Guilherme Diogo Silva	No disclosure on file
Vinicius A. Schoeps, MD	Dr. Schoeps has nothing to disclose.
Ana Beatriz Ayroza Galvao Ribeiro Gomes, MD (University Hospital Basel)	Dr. Ayroza Galvao Ribeiro Gomes has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Guidepoint. The institution of Dr. Ayroza Galvao Ribeiro Gomes has received research support from Roche.
Natalia T. Mendes, MD (Santa Casa de Misericórdia de São Paulo)	Dr. Mendes has nothing to disclose.
Aline d. Matos, MD	The institution of Dr. Matos has received research support from Hoffmann LaRoche.
Marina Solti, MD	Dr. Solti has nothing to disclose.
Pedro B. Torretta, MD (DFV neurologia)	Dr. Torretta has nothing to disclose.
Milena Pitombeira	No disclosure on file
Mateus Boaventura de Olivei, MD	Dr. Boaventura de Olivei has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Dr. Boaventura de Olivei has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche.
Renata Paolilo (University of São Paulo)	Renata Paolilo has nothing to disclose.
CAROLINA Rimkus (Faculdade de Medicina da Universidade de São Paulo)	No disclosure on file
Tarso Adoni, MD, PhD, FAAN	Dr. Adoni has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Adoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Adoni has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Adoni has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis.
Anne-Katrin Proebstel, MD (University Hospital Basel)	The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Proebstel has received research support from Biogen. Dr. Proebstel has received intellectual property interests from a discovery or technology relating to health care.
Douglas K. Sato, MD	Dr. Sato has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Sato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra-Zeneca. The institution of Dr. Sato has received research support from Biogen. The institution of Dr. Sato has received research support from Merck.
Dagoberto Callegaro, Sr., PhD (HC-FMUSP)	Dr. Callegaro has nothing to disclose.

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