Abstract
Abstract
Background
Myelin Oligodendrocyte Glycoprotein antibody-associated disease (MOGAD) is most classically associated in both children and adults with phenotypes including bilateral and recurrent optic neuritis (ON) and transverse myelitis (TM), with the absence of brain lesions characteristic of multiple sclerosis (MS). ADEM phenotype is the most common presentation of MOGAD in children. However, the presence of clinical phenotypes including unilateral ON and short TM in some patients with MOGAD may lead to their misdiagnosis as MS. Thus, clinically and radiologically, MOGAD can mimic MS and clinical vigilance is required for accurate diagnostic workup.
Case presentation
We present three cases initially diagnosed as MS and then treated with alemtuzumab. Unexpectedly, all three patients did quite poorly on this medication, with a decline in their clinical status with worsening of expanded disability status scale (EDSS) and an increasing lesion load on magnetic resonance imaging of the brain. Subsequently, all three cases were found to have anti-MOG antibody in their serum.
Conclusions
These cases highlight that if a patient suspected to have MS does not respond to conventional treatments such as alemtuzumab, a search for alternative diagnoses such as MOG antibody disease may be warranted.
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),General Medicine
Cited by
7 articles.
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1. Quality of life is impaired in myelin oligodendrocyte glycoprotein antibody associated disease;Multiple Sclerosis Journal - Experimental, Translational and Clinical;2024-07
2. MOG Antibody Disease: Nuances in Presentation, Diagnosis, and Management;Current Neurology and Neuroscience Reports;2024-05-28
3. MOG antibody-associated optic neuritis;Eye;2024-05-23
4. Optic Neuritis in the New Millennium;TNOA Journal of Ophthalmic Science and Research;2024-04
5. Neuromielitis óptica y enfermedad anti-MOG;Medicine - Programa de Formación Médica Continuada Acreditado;2023-05