MOG antibody seropositivity in a patient with encephalitis: beyond the classical syndrome

Background The presence of circulating anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) has been described in sera of patients with different inflammatory conditions of the central nervous system. In adults the core clinical feature is usually characterised by acute myelitis and/or opti...

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Published in:BMC neurology Vol. 17; no. 1; pp. 190 - 6
Main Authors: Mariotto, Sara, Monaco, Salvatore, Peschl, Patrick, Coledan, Ilaria, Mazzi, Romualdo, Höftberger, Romana, Reindl, Markus, Ferrari, Sergio
Format: Journal Article
Language:English
Published: London BioMed Central 05.10.2017
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Adult
Anti-myelin oligodendrocyte glycoprotein antibodies (MOG-abs)
Ataxia
Autoantibodies
Autoantibodies - blood
Autoimmune diseases
Care and treatment
Case Report
Case studies
Causes of
Central nervous system
Cerebrospinal fluid
Consciousness
Consortia
Cortex
Demyelinating diseases
Diagnosis
Encephalitis
Encephalitis - immunology
Family medical history
Fever
Genetic aspects
Humans
Immunoglobulins
Immunoglobulins, Intravenous - administration & dosage
Inflammation
Intravenous administration
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Multiple sclerosis
Myelin
Myelin proteins
Myelin-Oligodendrocyte Glycoprotein - immunology
Myelitis
Nervous system
Neuritis
Neurochemistry
Neuroimaging
Neurology
Neurosurgery
NMR
Nuclear magnetic resonance
Oligodendrocyte-myelin glycoprotein
Optic neuritis
Optic Neuritis - etiology
Patients
Pediatrics
Physiological aspects
Prognosis
Substantia alba
Italy
Austria
Anti-myelin oligodendrocyte glycoprotein antibodies (MOG-abs)
Autoimmune diseases
Encephalitis
ISSN:1471-2377, 1471-2377
Online Access:Get full text
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Summary:Background The presence of circulating anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) has been described in sera of patients with different inflammatory conditions of the central nervous system. In adults the core clinical feature is usually characterised by acute myelitis and/or optic neuritis. We here report an atypical case with serum and cerebrospinal fluid MOG-Abs and a clinical picture suggestive for acute encephalitis. Case presentation A 31-year-old Indian man presented with altered mental status, slight fever, and ataxia. Brain magnetic resonance imaging noted a widespread involvement of the white matter associated with slight cortical and subcortical damage in absence of contrast enhancement. An extensive infectious screening resulted negative while autoimmune analysis revealed the presence of MOG-Abs, detected with live cell-based assay. After treatment with intravenous immunoglobulins a marked and prompt clinical and radiological improvement was observed. Conclusions To date, several areas of uncertainty still remain regarding clinical features and prognosis of subjects with MOG-Abs. The description of atypical cases is crucial, since recognition of this condition leads to prompt treatment and better prognosis, as in the case here reported.
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ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-017-0971-6