ArticleAnnals of neurology2023
Alterations in Aquaporin-4-IgG Serostatus in 986 Patients: A Laboratory-Based Longitudinal Analysis.
Article in Annals of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- AQP4-IgG Dynamics and Exploratory Assessment of SERA-3 in Neuromyelitis Optica Spectrum Disorder Treated with Satralizumab.Neurology and therapy · 2026Article
- Use of Fluid Biomarkers in NMOSD and MOGAD: Clinical and Research Applications.Neurology(R) neuroimmunology & neuroinflammation · 2026Review
- Anti-CD320 Autoantibodies and Central Nervous System Vitamin B12 Deficiency in Idiopathic Myelopathy.JAMA neurology · 2026Article
- Aquaporin-4's dynamic expression and biological variations within the tumor obscure the paraneoplastic phenomenon in aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder.Acta neuropathologica · 2026Article
- Intrathecal immunoglobulin production in the diagnosis, prognosis, and monitoring of autoimmune diseases of the central nervous system.Journal of translational autoimmunity · 2026Review
- Comparative Effectiveness of Disease-Modifying Treatments in Double Seronegative Neuromyelitis Optica Spectrum Disorder.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Frequency of Seroconversion in Aquaporin-4 Antibody Testing: Insights From Real-World Data.Annals of clinical and translational neurology · 2025Article
- Ofatumumab treatment in patients with neuromyelitis optica spectrum disorder: a retrospective multicenter cohort study.Journal of neurology · 2025Article
- Fluctuations in serum aquaporin-4 antibody titers: the clinical significance in neuromyelitis optica spectrum disorder.Journal of neurology · 2025Article
- Is a Benign Disease Course Possible in Untreated AQP4-IgG NMOSD?European journal of neurology · 2025Article
- Real-world clinical experience with serum MOG and AQP4 antibody testing by live versus fixed cell-based assay.Annals of clinical and translational neurology · 2025Article
- Quantitative analysis of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies titres: correlation with relapses.Brain communications · 2025Article
- NMOSD and MOGAD: an evolving disease spectrum.Nature reviews. Neurology · 2024Review
- Moving towards a new era for the treatment of neuromyelitis optica spectrum disorders.Journal of neurology · 2024Review
- Updates in NMOSD and MOGAD Diagnosis and Treatment: A Tale of Two Central Nervous System Autoimmune Inflammatory Disorders.Neurologic clinics · 2024Review
- Human stem cell-derived neurons and astrocytes to detect novel auto-reactive IgG response in immune-mediated neurological diseases.Frontiers in immunology · 2024Article
- Patterns of cerebral damage in multiple sclerosis and aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders-major differences revealed by non-conventional imaging.Brain communications · 2024Article
- Update on the diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) - revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part II: Attack therapy and long-term management.Journal of neurology · 2024Review
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectiveThis study was undertaken to investigate factors associated with aquaporin-4 (AQP4)-IgG serostatus change using a large serological database.
methodsThis retrospective study utilizes Mayo Clinic Neuroimmunology Laboratory data from 2007 to 2021. We included all patients with ≥2 AQP4-IgG tests (by cell-based assay). The frequency and clinical factors associated with serostatus change were evaluated. Multivariable logistic regression analysis examined whether age, sex, or initial titer was associated with serostatus change.
resultsThere were 933 patients who had ≥2 AQP4-IgG tests with an initial positive result. Of those, 830 (89%) remained seropositive and 103 (11%) seroreverted to negative. Median interval to seroreversion was 1.2 years (interquartile range [IQR] = 0.4-3.5). Of those with sustained seropositivity, titers were stable in 92%. Seroreversion was associated with age ≤ 20 years (odds ratio [OR] = 2.25; 95% confidence interval [CI] = 1.09-4.63; p = 0.028) and low initial titer of ≤1:100 (OR = 11.44, 95% CI = 3.17-41.26, p < 0.001), and 5 had clinical attacks despite seroreversion. Among 62 retested after seroreversion, 50% returned to seropositive (median = 224 days, IQR = 160-371). An initial negative AQP4-IgG test occurred in 9,308 patients. Of those, 99% remained seronegative and 53 (0.3%) seroconverted at a median interval of 0.76 years (IQR = 0.37-1.68).
interpretationAQP4-IgG seropositivity usually persists over time with little change in titer. Seroreversion to negative is uncommon (11%) and associated with lower titers and younger age. Seroreversion was often transient, and attacks occasionally occurred despite prior seroreversion, suggesting it may not reliably reflect disease activity. Seroconversion to positive is rare (<1%), limiting the utility of repeat testing in seronegative patients unless clinical suspicion is high. ANN NEUROL 2023;94:727-735.
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