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Quest Diagnostics

Demyelinating disorders, including NMOSD, MOG, and MS

Differential diagnosis is critical for appropriate treatment

Neuromyelitis optica spectrum disorder (NMOSD) is an immune-mediated, chronic, and often relapsing inflammatory disease that predominantly affects the optic nerve and spinal cord. It can sometimes be mistaken for multiple sclerosis (MS), which is a disease that affects the central nervous system. Myelin oligodendrocyte glycoprotein (MOG) is an antibody that may be present in NMOSD and other autoimmune disorders. 

Diagnosis is critical because treatments for MS may be ineffective or harmful for patients with NMOSD1

Why order demyelinating disease testing from Quest

Our comprehensive test menu includes MOG, AQP4, and reflex options that can deliver clear, positive identification 

MOG testing is done only if AQP4 comes back negative, ensuring we are performing only clinically relevant tests to avoid unnecessary costs

Testing that can help deliver clear, positive identification 

Test name
NMO Spectrum Evaluation (AQP4 with Reflex to MOG), Serum
NMO Spectrum Evaluation (AQP4 with Reflex to MOG), CSF
AQP4 (NMO-IgG) Antibody with Reflex to Titer, Serum
AQP4 (NMO-IgG) Antibody with Reflex to Titer, CSF
MOG Antibody with Reflex to Titer, Serum
MOG Antibody with Reflex to Titer, CSF
Multiple Sclerosis Panel, CSF
Multiple Sclerosis Panel 1, CSF and Serum
Multiple Sclerosis Panel 2, CSF and Serum

References

1. Sato DK, Callegaro D, Lana-Peixoto MA, et al. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. Neurology. 2014;82(6):474-481.  doi:10.1212/WNL.0000000000000101

2. Kitley J, Waters P, Woodhall M, et al. Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study. JAMA Neurol. 2014;71(3):276-283. doi:10.1001/jamaneurol.2013.5857

3. Kezuka T, Usui Y, Yamakawa N, et al. Relationship between NMO-antibody and anti-MOG antibody in optic neuritis. J Neuroophthalmol. 2012;32(2):107-110. doi:10.1097/WNO.0b013e31823c9b6c

4. Waters P, Woodhall M, O’Connor KC, et al. MOG cell-based assay detects non-MS patients with inflammatory neurologic disease. Neurol Neuroimmunol Neuroinflamm. 2015;2(3):e89.doi:10.1212/NXI.0000000000000089 

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