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NMOSD Screen in HIV Myelopathy — SCE Infectious Diseases MCQ

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HardCNS InfectionNMOSD Screen in HIV MyelopathySCE Infectious Diseases

A person with controlled HIV develops a longitudinally extensive inflammatory myelitis spanning four vertebral segments. CSF excludes common infectious causes. Which serum tests are essential because they identify treatable inflammatory mimics?

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Correct answer: B — Serum aquaporin-4 IgG and MOG-IgG

The best answer is “Serum aquaporin-4 IgG and MOG-IgG”. Longitudinally extensive myelitis is a core NMOSD/MOGAD phenotype; serum cell-based assays can redirect treatment toward immunotherapy once compressive, vascular and infectious causes are excluded. Longitudinally extensive inflammatory myelitis requires serum aquaporin-4 testing and, when negative with a compatible phenotype, consideration of MOG-antibody-associated disease and other mimics.

Reference: International consensus recommendations for NMOSD diagnosis: https://jnnp.bmj.com/content/87/8/835