For some of our patients, negative retests of borderline FACS results were detected with the EUROIMMUN assay

For some of our patients, negative retests of borderline FACS results were detected with the EUROIMMUN assay. criteria, these patients should rather be described as possible MOG\EM. Of these, we classified 13 patients as unlikely MOG\EM in the presence of the red flag borderline MOG\IgG with negative MOG\IgG retest coincidence of 1 1 additional red flag. This group mainly consisted of patients diagnosed with MS (n?=?11). Frequency of cerebrospinal fluid (CSF\)specific oligoclonal bands (OCB) is significantly lower in definite vs possible and unlikely MOG\EM (a negative retest for MOG\IgG at least one additional red flag. 2.5. Analysis and statistics Descriptive statistics were used to summarize patient data. For categorical variables, absolute and relative frequencies are reported. For continuous variables, median and interquartile range (IQR), if deemed informative, also minimum (min.) and maximum (max.) are given. Frequencies of missing data are disclosed for each parameter. Group comparisons were performed with Kruskal\Wallis test as a nonparametric test. Chi\square test was used to calculate difference in OCB and clinical diagnosis distribution between MOG\EM groups. Statistical significance level was set to fulfilling the diagnostic criteria were excluded from further analyses. The remaining 37 patients fulfilling RLC the diagnostic criteria were included in the analyses. The female\to\male ratio was 1.6:1 (Figure?1). The median age at onset was 28.0?years (IQR 18.5\40.5, min. 9.0, max. 66.0). The last documented median EDSS was 2.0 (IQR 1.5\3.0, min. 0, max. 8.0). Open in a separate window Figure 1 Sex distribution of the cohort. Female (black bars) and male (white bars) patients according to the groups: whole cohort (all, n?=?37), definite (n?=?13), possible (n?=?11), and unlikely (n?=?13) MOG encephalomyelitis As part of routine clinical care, patients were given different diagnoses of demyelinating L-778123 HCl CNS disorders (Figure?2). Open in a separate window Figure 2 Diagnoses as given in clinical routine (before establishment of the term MOG encephalomyelitis (MOG\EM) and respective definition of diagnostic criteria). Black bars: whole cohort (n?=?37), dark gray bars: definite MOG\EM (n?=?13), light gray bars: possible MOG\EM (n?=?11), white bars: unlikely MOG\EM (n?=?13). For MS, the disease course is given, additionally. Autoimm., autoimmune; Bilat., bilateral; dis., disorder; inflamm., inflammatory; LETM, longitudinal extensive transverse myelitis; NMOSD, neuromyelitis optica spectrum disorder; ON, optic neuritis; L-778123 HCl PPMS, primary progressive MS; RION, relapsing inflammatory optic neuritis; RRMS, relapsing\remitting MS; SPMS, secondary progressive MS; unk., unknown Classified by EDSS functional system scores, symptoms at onset were almost equally poly (n?=?16)\ or monosymptomatic (n?=?18) with visual (n?=?12), sensory (n?=?13), and pyramidal (n?=?9) being the most frequent (Figure?3A). Open in a separate window Figure 3 A, First symptom at disease onset, classified by EDSS functional system scores. If more than 1 symptom was reported, patients were counted as polysymptomatic, otherwise monosymptomatic. Black bars: whole cohort (n?=?37), dark gray bars: definite MOG\EM (n?=?13), light gray bars: possible MOG\EM (n?=?11), white bars: unlikely MOG\EM (n?=?13). For two patients, classification by functional system score was not deemed appropriate (multifocal, meningo\/encephalomyelitis); for three patients, symptoms at onset were unknown. Monosympt., monosymptomatic; polysympt., polysymptomatic; unk., unknown. B, Syndrome at first manifestation. Black bars: whole cohort (n?=?37), dark gray bars: definite MOG\EM (n?=?13), light gray bars: possible MOG\EM (n?=?11), white bars: unlikely MOG\EM (n?=?13). For three patients, unknown syndrome at onset The syndrome at first manifestation L-778123 HCl was mainly spinal cord or optic nerve involvement (Figure?3B). 3.2. Evaluation of red flags and classification of likelihood of MOG\EM A large proportion of patients (24/37) demonstrated at least one red flag (Table?2) and should thus be defined as possible MOG\EM. 2 Most frequently, the MRI red flag lesions suggestive of MS was present (n?=?18/37). In 16/37 patients, MOG\IgG L-778123 HCl was detected at the assay cutoff. Progressive disease course was described in L-778123 HCl 5/37 patients. The MRI red flag silent increase in lesion burden was noted for 1/37 patient. With the classification described above, that is, adding the category unlikely, patients were categorized as definite (n?=?13), possible (n?=?11), and unlikely (n?=?13) MOG\EM. We classified one patient (pat. 26, Table?2) as unlikely with a single.