The study aimed to investigate the frequency and clinical features of immunoglobulin A antibodies against myelin oligodendrocyte glycoprotein (MOG-IgA) in patients with demyelinating central nervous system diseases and healthy controls. A total of 1339 patients and 110 healthy controls were included. Isolated MOG-IgA was identified in 18 patients but not in any of the healthy controls. The most common manifestation in patients with isolated MOG-IgA was myelitis. They also showed a higher frequency of brainstem syndrome compared to MOG-IgG patients. However, optic neuritis was less common. Patients with MOG-IgA and multiple sclerosis had fewer frequent cerebrospinal fluid oligoclonal bands compared to MOG-IgG/IgA seronegative multiple sclerosis patients. Moreover, most patients with isolated MOG-IgA presented clinical attacks after a recent infection or vaccination, suggesting a possible trigger role for these events. In summary, the presence of isolated MOG-IgA antibodies seems to be associated with distinct clinical features compared to MOG-IgG antibodies.

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