MOG-antibody-associated hypertrophic pachymeningitis

Area of Science:

• Neurology
• Immunology
• Neuroinflammation

Background:

• Myelin oligodendrocyte glycoprotein (MOG)-antibody-associated disease (MOGAD) presents a diverse clinical spectrum.
• The expanding understanding of MOGAD necessitates recognition of its varied manifestations.

Observation:

• A 57-year-old female experienced seizures, cognitive decline, and behavioral changes.
• Brain MRI showed diffuse pachymeningeal enhancement and hippocampal hyperintensities.
• Cerebrospinal fluid analysis was unremarkable, but MOG-antibody testing was positive.

Findings:

• The patient was diagnosed with MOG-antibody-associated hypertrophic pachymeningitis (HP).
• Treatment with steroids led to complete clinical and radiological resolution.
• This case highlights an unusual presentation of MOGAD.

Implications:

• Hypertrophic pachymeningitis should be considered in the differential diagnosis of MOG-antibody-associated disease.
• Testing for MOG-antibodies is recommended for patients presenting with unexplained HP.
• This finding broadens the clinical recognition of MOGAD.