Abstract:

Objective To discuss the clinical manifestations, magnetic resonance imaging (MRI) features, MOG-IgG testing, diagnostic criteria, treatment and prognosis of myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD). Methods We reported a case of adult MOGAD, and reviewed relevant literatures. Results A 38-year-old female presented with headache and blurred vision in both eyes for three days. She had a history of prodromal fever. The head MRI showed lesions and enhancement in the thalamus, basal ganglia, cerebral peduncle, and brainstem. Serum and cerebrospinal fluid antibody testing showed a weak positive MOG IgG at a 1:10 ratio in both serum and cerebrospinal fluid. She was diagnosed with MOGAD, mainly manifested as optic neuritis and brainstem encephalitis. The combination therapy of corticosteroid and rituximab was given, and the patient's symptoms were completely disappeared at the 4-month follow-up. Conclusion MOGAD is a rare, antibody-mediated infl ammatory demyelinating disorder of the central nervous system (CNS) with cardinal features of optic neuritis, myelitis, brainstem encephalitis, cerebral cortical encephalitis (often with seizures) and acute disseminated encephalomyelitis. New diagnostic criteria for MOGAD have recently been proposed by an international panel of experts in 2023. MOG-IgG detection is the key to diagnosing MOGAD. There is no clear guideline for MOGAD treatment. About 50% of patients will experience a recurrence.

Key words: MOGAD, demyelinating diseases, MOG-IgG