1/12/2024 0 Comments Anti mog ademThe ophthalmologic examination revealed a decreased visual acuity, loss of color vision, and the fundoscopy showed a left optic disc swelling. She had been healthy previously and had an unremarkable medical and family history. This study was approved by the institutional review board of the Soonchunhyang University Bucheon Hospital with informed consent (1).Ī 6-year-old Korean girl with sudden loss of vision in her left eye visited Soonchunhyang University Bucheon Hospital. Because few cases of MOG seropositivity have been reported in Asian children, we here describe a Korean child with recurrent unilateral ONs and a single ADEM episode who showed high titers of MOG antibodies. Therefore, new specific therapeutic strategies for anti-MOG antibody-associated disease are under development. Patients with anti-MOG antibodies appear to have a unique clinical, radiological, and therapeutic profile. High titers of anti-MOG antibodies are reported to be predominant in pediatric patients with acquired inflammatory demyelinating diseases of the CNS such as recurrent ONs, ADEM followed by ON, and multiphasic disseminated encephalomyelitis. Recently, antibodies against myelin oligodendrocyte glycoprotein (MOG) have gained attention. Many demyelinating disease-associated antibodies have been described as important diagnostic and prognostic biomarkers. Inflammatory demyelinating central nervous system (CNS) diseases as diverse as neuromyelitis optica (NMO), multiple sclerosis (MS), transverse myelitis, acute disseminated encephalomyelitis (ADEM), or optic neuritis (ON) have shared clinical, radiological, and immunological features, particularly at onset. ![]() Key words: Brain diseases Child Myelin-oligodendrocyte glycoprotein Optic neuritis Testing for anti-MOG antibodies is highly recommended for relapsing inflammatory demyelinating central nervous system diseases in pediatric patients, in order to define early an adequate long-term treatment. After the 3rd episode, anti-MOG antibody testing was performed and higher titer was detected. Throughout these three episodes, serological tests associated with autoimmune diseases, viral markers, anti-aquaporin-4 antibodies, and cerebrospinal fluid oligoclonal bands were negative, with the immunoglobulin G index in the normal range. Despite regular interferon β-1a injection after steroid tapering, she developed a 3rd episode presenting as a right ON. Her vision improved dramatically after steroid therapy however, 3 months after the 1st episode, she developed acute encephalopathy with extensive newly developed ADEM-like lesions and resolution of previous hyperintensities. Initially, she suffered from left ON with subclinical brain lesions including magnetic resonance imaging hyperintensities in the bilateral frontal subcortical white matter, the left thalamus, and the right cerebral peduncle. ![]() Here, we report the case of a 6-year-old Korean girl with recurrent steroid-responsive optic neuritis (ON) and an episode of acute disseminated encephalomyelitis (ADEM) with a high MOG antibody titer. Myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases are reported to have distinct pathogenic mechanisms, clinical courses, and therapeutic implications in comparison to other acquired demyelinating syndromes.
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