Factors associated with the misdiagnosis of neuromyelitis optica spectrum disorder

Smith, Alexander D.; Moog, Tatum M.; Burgess, Katy W; McCreary, Morgan; Okuda, Darin T.

doi:10.1016/j.msard.2023.104498

Cited by 15 publications

(2 citation statements)

References 35 publications

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“…Those with rapid succession of relapses have a higher risk of developing generalized demyelinating disease. However, the MOG subset of this disease has been associated with a better prognosis than those who test positive for aquaporin-4 antibodies [ 16 ]. Again, patients with persistent MOG-positive antibody are considered to have a poor prognosis for the recurrence of MOG-AD.…”

Section: Discussionmentioning

confidence: 99%

Acute-Onset Blindness in a Patient Diagnosed With Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOG-AD): A Case Report

Gyabaah,

Petersen,

Bateman

et al. 2024

Cureus

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Myelin oligodendrocyte glycoprotein antibody disease (MOG-AD) poses a diagnostic challenge, often masquerading as other neurological disorders such as multiple sclerosis and aquaporin-4-positive neuromyelitis optica spectrum disorder. The deceptive clinical similarities demand a nuanced approach to differentiate these conditions effectively. This entails an extensive evaluation encompassing a meticulous medical history, advanced magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and serum studies. In this context, we present a compelling case involving a 28-year-old Hispanic female with a history of migraine headache. She sought medical attention due to acute peripheral vision loss, ultimately diagnosed as MOG-AD through a comprehensive clinical assessment coupled with specific diagnostic tests. This case underscores the critical importance of precision in diagnostic procedures to ensure accurate identification and subsequent tailored treatment for MOG-AD, avoiding potential pitfalls associated with its resemblance to other neurological disorders.

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Section: Discussionmentioning

confidence: 99%

Acute-Onset Blindness in a Patient Diagnosed With Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOG-AD): A Case Report

Gyabaah,

Petersen,

Bateman

et al. 2024

Cureus

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“…Previous studies have suggested that patients with NMOSD are often misdiagnosed as having multiple sclerosis (MS) or other disorders [2][3][4][5], but only a few studies, other than case reports, have investigated what disorders are mistaken for NMOSD [6]. While MS and MOG-IgG-associated disease (MOGAD) represent the main differential diagnoses for NMOSD in clinical practice, and several studies have highlighted clinical-MRI differences between these three entities [7][8][9], non-demyelinating disorders that can mimic NMOSD are rare and likely underrecognized, which may lead to them being incorrectly diagnosed as seronegative NMOSD.…”

Section: Introductionmentioning

confidence: 99%

Non‐demyelinating disorders mimicking and misdiagnosed asNMOSD:a literature review

Zara

Dinoto

Carta

et al. 2023

Euro J of Neurology

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BackgroundDifferentiating neuromyelitis optica spectrum disorder (NMOSD) from its mimics is crucial to avoid misdiagnosis, especially in the absence of aquaporin‐4‐IgG. While multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein‐IgG associated disease (MOGAD) represent major and well‐defined differential diagnoses, non‐demyelinating NMOSD mimics remain poorly characterized.MethodsWe conducted a systematic review on PubMed/MEDLINE to identify reports of patients with non‐demyelinating disorders that mimicked or were misdiagnosed as NMOSD. Three novel cases seen at the authors' institutions were also included. The characteristics of NMOSD mimics were analyzed and red flags associated with misdiagnosis identified.ResultsA total of 68 patients were included; 35 (52%) were female. Median age at symptoms onset was 44 (range, 1–78) years. Fifty‐six (82%) patients did not fulfil the 2015 NMOSD diagnostic criteria. The clinical syndromes misinterpreted for NMOSD were myelopathy (41%), myelopathy + optic neuropathy (41%), optic neuropathy (6%), or other (12%). Alternative etiologies included genetic/metabolic disorders, neoplasms, infections, vascular disorders, spondylosis, and other immune‐mediated disorders. Common red flags associated with misdiagnosis were lack of cerebrospinal fluid (CSF) pleocytosis (57%), lack of response to immunotherapy (55%), progressive disease course (54%), and lack of magnetic resonance imaging gadolinium enhancement (31%). Aquaporin‐4‐IgG positivity was detected in five patients by enzyme‐linked immunosorbent assay (n = 2), cell‐based assay (n = 2: serum, 1; CSF, 1), and non‐specified assay (n = 1).ConclusionsThe spectrum of NMOSD mimics is broad. Misdiagnosis frequently results from incorrect application of diagnostic criteria, in patients with multiple identifiable red flags. False aquaporin‐4‐IgG positivity, generally from nonspecific testing assays, may rarely contribute to misdiagnosis.

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High-efficacy therapies reduce clinical and radiological events more effectively than traditional treatments in neuromyelitis optica spectrum disorder

et al. 2023

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Factors associated with the misdiagnosis of neuromyelitis optica spectrum disorder

Cited by 15 publications

References 35 publications

Acute-Onset Blindness in a Patient Diagnosed With Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOG-AD): A Case Report

Acute-Onset Blindness in a Patient Diagnosed With Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOG-AD): A Case Report

Non‐demyelinating disorders mimicking and misdiagnosed asNMOSD:a literature review

High-efficacy therapies reduce clinical and radiological events more effectively than traditional treatments in neuromyelitis optica spectrum disorder

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