MOG antibody associated demyelinating syndrome presenting as aseptic meningitis in a 6-year-old boy

Area of Science:

• Neuroimmunology
• Pediatric Neurology
• Demyelinating Diseases

Background:

• Myelin oligodendrocyte glycoprotein antibody (MOG-Ab) associated demyelinating syndrome is an immune-mediated condition affecting the central nervous system.
• While MOG-Ab associated demyelinating syndrome is recognized, its presentation can vary, with some cases mimicking infectious meningitis.

Observation:

• A 6-year-old boy initially presented with symptoms suggestive of aseptic meningitis.
• Cerebral and spinal lesions consistent with acute disseminated encephalomyelitis were identified via magnetic resonance imaging.
• The patient experienced rapid clinical improvement following high-dose intravenous methylprednisolone therapy.

Findings:

• This case represents the first documented pediatric instance of MOG-Ab associated demyelinating syndrome presenting as aseptic meningitis.
• Previously, this specific clinical presentation of MOG-Ab associated demyelinating syndrome has been reported primarily in adults.

Implications:

• Recognizing aseptic meningitis as a potential early sign of MOG-Ab associated demyelinating syndrome in children is crucial for timely diagnosis.
• This finding expands the known spectrum of MOG-Ab associated demyelinating syndrome phenotypes in pediatric populations.
• Early diagnosis and appropriate treatment, such as corticosteroids, can lead to favorable outcomes in pediatric MOG-Ab associated demyelinating syndrome.