An Emerging Autoimmune Neuroinflammatory Disease: Myelin Oligodendrocyte Glycoprotein Antibody Disease.
Satbir Kaur Malik, Atharvan Sharma Mangalapalli, Hemanjali Avuthu
✦ AI-curated · Sources linked
Case in brief
A 40-year-old woman presented with fever, acute left visual impairment and pain with eye movement, ataxia, dizziness, bitemporal headache, and urinary retention. Cerebrospinal fluid showed lymphocytic pleocytosis, serum anti-MOG antibodies were positive at 1:100, and MRI demonstrated lesions in the diencephalon, brainstem, periventricular white matter, and conus medullaris. After intravenous methylprednisolone followed by a tapering course of oral prednisolone, she recovered completely. At one-year follow-up, serum anti-MOG antibodies were negative and brain and spinal MRI lesions had resolved.
What made this case unusual
The presentation combined optic symptoms and multifocal brain lesions with conus medullaris involvement and urinary retention, alongside positive serum anti-MOG antibodies.
Diagnostic / clinical pearl
In a patient with multifocal demyelinating lesions and a compatible clinical syndrome, serum anti-MOG antibody testing can help identify MOGAD as distinct from multiple sclerosis and AQP4-IgG-positive NMOSD.