Demyelinating disease
Similar characteristics. Different treatments.
The clinical and radiologic features of neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein (MOG-IgG) associated disease (MOGAD), and MS are similar. However, the appropriate treatments for MOGAD and NMOSD are significantly different than for MS.
- MS is treated by immunomodulation therapy, which may worsen NMOSD.
- NMOSD and MOGAD are treated by immunosuppressant therapy.
An accurate diagnosis of these diseases is critical for physicians and their patients.
“The value of better testing is translated into better answers from the lab to providers and to patients, and to all clients of the laboratory.”
Maria Alice Willrich, Ph.D., co-director, Antibody Immunology, Protein Immunology, and Clinical Mass Spectrometry laboratories
News and updates
The latest
Learn more about the risks of false positives with AQP4 ELISA methodology in CNS demyelinating disease testing.
Joe Mondloch and his wife Sue have existed in a grey area of uncertainty due to the unpredictable autoimmune neurological illness Joe has lived with for the last seven years. Rare, incurable, and debilitating, the newly classified disorder can be hard to manage. But thanks to information and direction provided by a rare disease advocacy group, the Mondlochs sought care at Mayo Clinic and received much more than answers.
In this month's "Hot Topic," Eoin Flanagan, M.B., B.Ch., reviews the recent diagnostic criteria for Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (MOGAD).
In this test-specific episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic, and Bjorn Oskarsson, M.D., a neurologist at Mayo Clinic’s Florida campus, discuss how the neurofilament light chain test available through Mayo Clinic Laboratories helps physicians diagnose neurological disease and assess neuronal damage.
Alicia Algeciras, Ph.D., describes Mayo Clinic Laboratories’ new blood test to detect NFLC, or neurofilament light chain protein. NFLC is a biomarker for several neurodegenerative conditions. The new assay can determine if a patient’s cognitive decline is due to a neurodegenerative condition or some other, reversible condition — while avoiding the need for more-invasive testing of cerebrospinal fluid.
Mayo Clinic researchers have identified clear differences in brain and spinal cord scarring in patients with demyelinating diseases.
Maria Alice Willrich, Ph.D., explains kappa free light chain testing — Mayo Clinic Laboratories' data-driven approach to diagnose multiple sclerosis. The automated assay is more sensitive, cost-effective, and faster than traditional oligoclonal banding, enabling definitive answers for the challenging diagnosis.
Lying in an ICU bed as sick as he could get, Jon Bratsch thought he was past the point of no return. But when a Mayo Clinic Laboratories’ test revealed the source of his dire symptoms, everything changed. Today, Jon’s back to the life and family he loves.
John Mills, Ph.D., explains Mayo Clinic Laboratories’ approach to MAG antibody testing. The ELISA-based assay uses higher reference ranges and human MAG antigen to detect MAG antibodies, which are associated with a rare, hard-to-treat condition known as DADS neuropathy.
In this month’s “Hot Topic,” Andrew McKeon, M.B., B.Ch., M.D., reviews the use of neurological phenotype-based evaluations, the move away from the paraneoplastic evaluation, and upcoming changes to test profiles.
Mayo Clinic Laboratories is the only laboratory in the world to offer testing for a novel form of autoimmune meningoencephalomyelitis. Known as autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy, the condition was identified by Mayo Clinic in 2016. The GFAP antibody test is offered as part of Mayo Clinic Laboratories’ encephalitis and myelopathy evaluations.
Patients with autoimmune myelopathy present with subacute onset and rapid progression of spinal cord symptoms (weakness, gait difficulties, loss of sensation, neuropathic pain, and bowel and bladder dysfunction). Autoimmune myelopathy evaluation of serum and spinal fluid can assist in the diagnosis and aid distinction from other causes of myelopathy (multiple sclerosis, sarcoidosis, and vascular disease). Early diagnosis may assist in diagnosis of occult cancer, prompt initiation of immune therapies, or both.
Antibodies to aquaporin-4 and myelin oligodendrocyte glycoprotein (MOG) are recently described biomarkers seen in a subset of atypical optic neuritis which have revolutionized our understanding of the condition. In this “Hot Topic,” my colleague, Dr. John Chen, will review these advances and how they impact the clinical care of our patients with optic neuritis.