Pediatric Transverse Myelitis with Positive Anti-MOG Antibody
Article Sidebar
Main Article Content
Abstract
Background : Antibody against myelin oligodendrocyte glycoprotein is associated with various central nervous system demyelination especially patient with clinical diagnosis of neuromyelitis optica spectrum disorder (NMO-SD) or certain CNS demyelinating disease but negative for anti-aquaporin-4. We present a pediatric patient with clinically diagnosed with long segments transverse myelitis with positive anti-MOG antibody.
Findings : An eleven-year-old patient presented with weakness on both legs and decreased sensation below T6 level. Magnetic resonance imaging of spine revealed intramedullary hypersignal intensity of spinal cord from C5 to T11 level with skipped lesion at T12 to conus medullaris. Serology studies were negative for oligoclonal band and anti-aquaporin-4 but positive for anti-MOG. Patient was treated with intravenous pulse methylprednisolone for five days and partially recovered.
Conclusion : Anti-MOG antibody may be suspected in patient who clinically presented with NMO-SD but negative for aquaporin-4 antibody and oligoclonal band.
Article Details
บทความที่ได้รับการตีพิมพฺเป็นลิขสิทธิ์ของวารสาร
References
spinal cord inflammation. J Neurol Sci. 2012; 313:182–84.
2. Papadopoulos MC, Verkman AS. Aquaporin 4 and neuromyelitis optica. Lancet Neurol. 2012.11(6);535–54.
3. Lennon VA, Wingerchuk DM, Kryzer TJ, et al. A serum autoantibody marker of neuromyelitisoptica: distinction
from multiple sclerosis. Lancet. 2004;364:2106–12.
4. Rostasy K, Mader S, Schanda K, Huppke P, Gartner J. Anti–Myelin Oligodendrocyte GlycoproteinAntibodies in
Pediatric Patients with Optic Neuritis. Arch Neurol. 2012;69:752-6.
5. Rostasy K, Mader S, Hennes EM, Schanda K, Gredler V, et al. Persisting myelin oligodendrocyte glycoprotein
antibodies in aquaporin-4 antibody negative pediatric neuromyelitis optica. Multiple sclerosis journal.
2012:19(8);1052–9.
6. Probstel A, Rudolf G, Dornmair K, Collongues N, Chanson J, et al. Anti-MOG antibodies are presented in a
subgroup of patients with neuromyelitis optica phenotype. Journal of Neuroinflammation. 2015:12:46.
7. Johns TG, Bernard CC. The structure and function of myelin oligodendrocyte glycoprotein. J Neurochem.
1999:72;1-9.
8. Breithaupt C, Schubart A, Zander H, Skerra A, Huber R. Structural insights into antigenicity of myelin
oliodendrocyte glycoprotein. Proc Natl Acad Sci. 2003;100(16):9446–51.
9. dos Passos GR, Oliveira LM, da Costa BK, Apostolos-Pereira SL, Callegaro D, et al. MOG-IgG-Associated optic
neuritis, encephalitis and myelitis: Lessons learned from neuromyelitis optica spectrum disorder Front Neurol.
2018;9:217.
10. Jarius S, Ruprecht K, Kleiter I, Borisow N, Asgarin N, et al. MOG-IgG in NMO and related disorder: a muylticenter
study of 50 patients. Part 1: frequency, syndrome specificity, influence of disease acitivity, long term course
association with AQP4-IgG, and origin. J Neuroinflamm. 2016;13:279.
11. Bergamaschi R, Tonietti S, Franciotta D, Candeloro E, Tavazzi E, et al. Oligoclonal band in Devic’s neuromyeltis
optica and multiple sclerosis: difference in repeated cerebrospinal fluid examination. Mult Scler. 2004;10(1);2-4.
12. Jarius S, Paul F, Aktas O, Asgari N, Dale RC, et al. MOG encephalomyelitis: international recommendations on
diagnosis and antibody testing. Journal of Neuroinflammation. 2018;15:134.
13. Deneve M, Biotti D, Patsoura S, Ferrier M, Meluchova Z, et al. MRI features of demyelinating disease associated
with anti-MOG antibodies in adults. Journal of Neuroradiology.2019;46:312–31.
14. Wynford-Thomas R, Jacob A, Tomassini V. Neurological update: MOG antibody disease. Journal of Neurology.
2019;266:1280–6.
15. Oshiro A, Nakamura S, Tamashiro K, Fujihara K. Anti-MOG + neuromyelitis optica spectrum disorder treated with
plasmapheresis. No To Hattatsu. 2016;48:199-203.
16. Papadopoulos MC, Bennett JL, Verkman AS. Treatment of neuromyelitis optica: state-of-the-art and emerging
therapies. Nat Rev Neurol. 2014;10:493-506.
17. Bernard-Valnet R, Liblau RS, Vukusic S. Marignier R. Neuromyelitis optica: a positive appraisal of seronegative
cases. Eur J Neurol. 2015;22(12):e82-3