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HelpTest Code LAB8869 Myelin Oligodendrocyte Glycoprotein (MOG-IgG1) Fluorescence-Activated Cell Sorting (FACS) Assay, Serum
Additional Codes
MOGFS
Specimen Required
Patient Preparation: For optimal antibody detection, specimen collection should occur prior to initiation of immunosuppressant medication.
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send 1 of the following with the specimen:
-Neurology Specialty Testing Client Test Request (T732)
-General Request (T239)
Secondary ID
65563Useful For
Diagnosis of inflammatory demyelinating diseases (IDD) with similar phenotype to neuromyelitis optica (NMO) spectrum disorder (NMOSD), including optic neuritis (single or bilateral) and transverse myelitis
Diagnosis of autoimmune myelin oligodendrocyte glycoprotein (MOG)-opathy
Diagnosis of NMO
Distinguishing NMOSD, acute disseminated encephalomyelitis (ADEM), optic neuritis, and transverse myelitis from multiple sclerosis early in the course of disease
Diagnosis of ADEM
Prediction of a relapsing disease course
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| MOGTS | MOG FACS Titer, S | No | No |
Testing Algorithm
When the results of this assay require further evaluation, the reflex titer test will be performed at an additional charge.
Method Name
Flow Cytometry
Specimen Type
SerumSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
On-campus collections: Tube to 99 or deliver to University Extension Hospital Room EH318
Off-campus collections: Centrifuge and aliquot within 2 hours. Specimen to be stored/transported Refrigerated.
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
Negative
Method Description
MOG-IgG1 Fluorescence-Activated Cell-Sorting Assay
Human embryonic kidney cells (HEK 293) are transfected transiently with a DNA plasmid that allows coexpression of both a reporter fluorescent protein (green fluorescent protein: AcGFP) and full-length MOG. After 36 hours, a mixed population of cells (transfected expressing MOG on the surface and AcGFP in the cytoplasm and nontransfected lacking MOG and AcGFP) are lifted and resuspended in live cell-binding buffer. Cells are incubated with patient serum, and an AlexaFluor 647-labeled secondary antibody is added. Two populations are gated based on AcGFP expression: positive (high MOG expression) and negative (low or no MOG expression). Positivity is based on the ratio (positive >2.5) of the median fluorescence intensity (MFI) of each cell population (MFI GFP positive:MFI GFP negative).(Unpublished Mayo method)
If MOG-IgG1 cell-based flow cytometry (fluorescence-activated cell-sorting assay: FACS) assay is positive at screening dilution, the MOG-IgG1 flow cytometry titer assay is performed at an additional charge.(Unpublished Mayo method)
Day(s) Performed
Monday, Tuesday, Thursday
Report Available
5 to 8 daysSpecimen Retention Time
28 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
86363
86363-titer (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MOGFS | MOG FACS, S | 90248-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 65563 | MOG FACS, S | 90248-6 |
Interpretation
A positive value for myelin oligodendrocyte glycoprotein (MOG)-IgG is consistent with a neuromyelitis optica-like phenotype and, in the setting of acute disseminated encephalomyelitis, optic neuritis and transverse myelitis, indicates an autoimmune oligodendrogliopathy with potential for relapsing course. Identification of MOG-IgG allows distinction from multiple sclerosis (MS) and may justify initiation of appropriate immunosuppressive therapy (not MS disease-modifying agents) at the earliest possible time. This allows early initiation and maintenance of optimal therapy. Recommend follow-up in 6 to 12 months, as persistence of MOG-IgG seropositivity predicts a relapsing course.
This autoantibody is not found in healthy subjects.