Skip to content
DraconiticResearch
Search Sources API
197,768 studies31 sourcesUpdated 36 min ago
Peer-reviewedCC BY 4.0Frontiers in Neurology

Reclassification of acute inflammatory myelopathies in the antibody era: from AQP4-IgG and MOG-IgG to double-seronegative disease

  • Ping Fan1
  • Youlin Tan2
  • Zhen Ren2
  • Qi Zhang1
  1. 1Department of Neurology, Jiangxi Province Hospital of Integrated Chinese and Western Medicine
  2. 2Graduate School, Jiangxi University of Traditional Chinese Medicine
Open at sourceDOICite

Abstract

Acute inflammatory myelopathy refers to a heterogeneous group of acute or subacute spinal cord syndromes characterized by clinical features suggestive of inflammatory involvement. Although these diseases have overlapping clinical manifestations, their underlying mechanisms, disease progression, and classification systems remain heterogeneous. The discovery of AQP4-IgG and MOG-IgG has driven a shift from a “syndrome-based nomenclature” to a “disease-specific classification,” allowing some patients previously classified as transverse myelitis or seronegative NMOSD to be reclassified as more specific disease entities. However, AQP4-IgG/MOG-IgG double-negative cases remain highly heterogeneous, including double-negative NMOSD, multiple sclerosis (MS), other immune-mediated myelopathies, and non-inflammatory mimics. Additionally, testing conditions may also affect whether a patient is classified as seronegative. This narrative review examines the roles of antibody stratification, MRI, and cerebrospinal fluid in the classification of acute inflammatory myelopathy, focusing on the disease composition of double-negative cases and longitudinal reclassification. Existing evidence supports interpreting double-seronegative status as a serological classification state rather than an independent disease entity. Some patients initially unclassified may be reclassified into specific disease categories during longitudinal follow-up.

Related

  1. Outcomes and Reclassification Patterns in Inflammatory Bowel Disease Unclassified: A Multicenter Study Matched With Ulcerative Colitis From Spanish ENEIDA Registry
    M. González‐Vivó, B. Castro Senosiain, I. Pérez‐Martínez +21
    Journal of Gastroenterology and HepatologyPeer-reviewedCC BY-NC-ND 4.0Full textGeneral medicinePMC
  2. Vimentin neutralizing antibody ameliorate inflammatory bowel disease by inhibiting fibrosis and inflammatory cell death
    Sol Kim, Hye Yeon Kang, Jin-Sil Park +6
    PLOS OnePeer-reviewedCC BYFull textDevelopmental biologyImmunologyPLOSEurope PMC
  3. Unusual Vascular Claudication in a Seronegative Patient: Raynaud's Phenomenon or Atypical Buerger Disease
    Umar Rehman, Abhinav Shoor, Abdulhaadi Khan +1
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  4. Gallium-68 (68Ga)-Labelled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in the Initial Staging of High-Risk Prostatic Adenocarcinoma: Reclassification to Oligometastatic Disease and Change in Treatment Intent
    Carlos Paul Villalba-Meneses, Adriana P Noboa, Veronica Marcela Villegas-Paredes
    CureusPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  5. Nephrotic range proteinuria and rapid progression to end-stage kidney disease in seronegative pauci-immune necrotizing glomerulonephritis masked by cutaneous lesions: a case-based review.
    Aleksandra Gałan, Filip Koszałka, Izabela Zakrocka +4
    Rheumatology internationalPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{fan2026reclassification,
  title = {{Reclassification of acute inflammatory myelopathies in the antibody era: from AQP4-IgG and MOG-IgG to double-seronegative disease}},
  author = {Ping Fan and Youlin Tan and Zhen Ren and Qi Zhang},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = nov,
  doi = {10.3389/fneur.2026.1994489},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1994489/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Reclassification of acute inflammatory myelopathies in the antibody era: from AQP4-IgG and MOG-IgG to double-seronegative disease
AU  - Ping Fan
AU  - Youlin Tan
AU  - Zhen Ren
AU  - Qi Zhang
PY  - 2026
DA  - 2026/11/05
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1994489
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1994489/full
AB  - Acute inflammatory myelopathy refers to a heterogeneous group of acute or subacute spinal cord syndromes characterized by clinical features suggestive of inflammatory involvement. Although these diseases have overlapping clinical manifestations, their underlying mechanisms, disease progression, and classification systems remain heterogeneous. The discovery of AQP4-IgG and MOG-IgG has driven a shift from a “syndrome-based nomenclature” to a “disease-specific classification,” allowing some patients previously classified as transverse myelitis or seronegative NMOSD to be reclassified as more specific disease entities. However, AQP4-IgG/MOG-IgG double-negative cases remain highly heterogeneous, including double-negative NMOSD, multiple sclerosis (MS), other immune-mediated myelopathies, and non-inflammatory mimics. Additionally, testing conditions may also affect whether a patient is classified as seronegative. This narrative review examines the roles of antibody stratification, MRI, and cerebrospinal fluid in the classification of acute inflammatory myelopathy, focusing on the disease composition of double-negative cases and longitudinal reclassification. Existing evidence supports interpreting double-seronegative status as a serological classification state rather than an independent disease entity. Some patients initially unclassified may be reclassified into specific disease categories during longitudinal follow-up.
SN  - 1664-2295
ER  -