MOG antibody seropositive aseptic meningitis: A new clinical phenotype

Divya Nagabushana1, Rutul Shah1, Hima Pendharkar2

  • 1Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.

Insights

This case report details a unique presentation of aseptic meningitis with brain demyelination, confirmed by myelin oligodendrocyte glycoprotein antibodies (MOG-Ab). Prompt steroid treatment led to significant recovery, highlighting MOG-Ab associated demyelination

Area of Science:

  • Neurology
  • Immunology
  • Neuroinflammation

Background:

  • The spectrum of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) associated demyelination is continually expanding.
  • MOG-Ab associated demyelinating diseases can present with diverse neurological manifestations.

Observation:

  • A 22-year-old female presented with aseptic meningitis symptoms including fever, headache, vomiting, and neck stiffness.
  • Neuroimaging revealed demyelinating lesions in the brain (caudate, temporal lobe, insula) with leptomeningeal enhancement.
  • Extensive workup excluded infectious and inflammatory causes, but serum tested positive for MOG-Abs.

Findings:

  • The patient exhibited a unique presentation of MOG-Ab associated demyelination mimicking acute disseminated encephalomyelitis with aseptic meningitis.
  • Serological testing confirmed the presence of MOG-Abs on two separate occasions.
  • The patient demonstrated significant clinical and radiological improvement following corticosteroid therapy.

Implications:

  • This case expands the known clinical spectrum of MOG-Ab associated demyelinating disorders.
  • Early diagnosis and treatment with steroids can lead to favorable outcomes in MOG-Ab associated demyelination.
  • Further research is warranted to understand the diverse presentations of MOG-Ab associated neurological conditions.

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