Three MOG positive cases had a prototypical multiple sclerosis diagnosis (RRMS n = 2, titers 1:20 and 1:40 PPMS n = 1 1:100).

Using a ≥1:40 titer cutoff, 65 (3.5%) tested positive and PPV was 93.8%. Of 1,877 patients tested, 78 (4.2%) patients tested positive for MOG-IgG with titer ≥1:20, and of these, 67 had validated MOG-AD yielding a PPV of 85.9%. MOG-IgG positive cases were reviewed for fulfillment of typical MOG-AD clinical features, determined by treating neurologists and study authors. All were tested via the MOG-IgG1 fluorescence-activated cell sorting assay (Mayo Laboratories, Rochester, MN). The Massachusetts General Brigham Research Patient Data Registry database was queried for patients with positive serum MOG-IgG detection, at least once, between Januand March 25, 2021. In this real-world institutional cohort study, we determined the PPV of serum MOG-IgG for clinically defined MOG-AD in our patient population. PPV may vary depending upon the tested population, thus supporting further investigation of MOG-IgG testing at other centers. 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.

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. 2Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.Klawiter 1, Tanuja Chitnis 2, Michael Levy 1 and Marcelo Matiello 1

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