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- W2206589723 abstract "Background Antibodies to myelin oligodendrocyte glycoprotein (MOG) occur in about 25% of children with multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM). We present a rare case of relapsing MOG antibody associated encephalomyelitis in a child, not associated with MS or ADEM. Case A previously well eleven year old girl presented with double vision, paraplegia, and lower limb hypersensitivity. An MRI scan showed changes consistent with transverse myelitis and she was treated with systemic steroids. After an initial improvement, she worsened with significant lower limb weakness and lost bowel and bladder control. Extensive investigations revealed positive serum MOG antibodies with negative CSF oligoclonal bands. Despite multiple cycles of plasmapheresis, she continued to deteriorate, requiring intubation and ventilation and a subsequent tracheostomy. With aggressive immune therapy using rituximab and cyclophosphamide for twelve months, she had no further relapses but remained ventilator dependent with severe paraparesis. Two months later, she re-presented with diplopia, acute lower limb hypersensitivity and subcortical myoclonus. Repeat investigations were in keeping with a relapse. She was treated with steroids, rituximab and cyclophosphamide with resolution of the new symptoms. Discussion MOG antibodies have been shown to induce demyelination. However, the clinical course of MOG antibody associated encephalomyelitis in a child without MS or ADEM is poorly described in literature. A recent study suggests that positive serum MOG antibodies may confer a better prognosis in relation to the clinical course of encephalomyelitis. However, cases associated with relapse are now emerging as part of an expanding spectrum and are much more difficult to manage despite aggressive immunotherapy. Conclusion Our case highlights the potential relapsing nature of MOG antibody associated encephalomyelitis, posing a challenge to management. Clinicians should be alert to this possibility, enabling appropriate counselling for patients and their families regarding potential long-term adversities." @default.
- W2206589723 created "2016-06-24" @default.
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- W2206589723 date "2015-05-01" @default.
- W2206589723 modified "2023-09-27" @default.
- W2206589723 title "PP08.6 – 2786: Relapsing MOG antibody associated encephalomyelitis: A case report" @default.
- W2206589723 doi "https://doi.org/10.1016/s1090-3798(15)30202-6" @default.
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