Myelin oligodendrocyte glycoprotein antibody-associated disease/paediatric multiple sclerosis overlap: a diagnostic
Taro Higuchi1, Itaru Hayakawa2, Hiroshi Sakuma3
1Center for Postgraduate Education and Training, National Center for Child Health and Development, Setagaya-ku, Japan.
Insights
This case study highlights diagnostic challenges in pediatric acquired demyelinating syndromes, showing overlap between Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) and pediatric Multiple Sclerosis (MS). Early MOGAD diagnosis and treatment improved vision, aiding differentiation.
Area of Science:
- Neuroimmunology
- Pediatric Neurology
- Ophthalmology
Background:
- Acquired demyelinating syndromes in children present diagnostic challenges due to overlapping features.
- Advancements in classification aid diagnosis, but complex cases require careful evaluation.
Observation:
- A young Asian girl experienced acute visual loss with optic neuritis and atrophy.
- Brain imaging revealed juxtacortical demyelinating lesions.
- Elevated anti-myelin oligodendrocyte glycoprotein antibody confirmed MOGAD.
Findings:
- The patient met criteria for MOGAD and potentially for pediatric Multiple Sclerosis (MS).
- Corticosteroid treatment led to visual recovery without recurrence.
- Optic nerve atrophy persisted despite normal visual acuity, favoring MOGAD over MS.
Implications:
- This case underscores the diagnostic complexity and potential overlap between MOGAD and pediatric MS.
- Highlights the importance of specific antibody testing in differentiating these conditions.
- Emphasizes MOGAD as a distinct entity in pediatric demyelinating disorders.
Abstract:
While advancements in the classification of acquired demyelinating syndromes have significantly benefited children with this condition, some cases present with overlapping features, posing diagnostic challenges. We describe an Asian girl of early childhood age with acute visual loss. Examination revealed right optic neuritis, left optic nerve atrophy and demyelinating lesions in the juxtacortical brain parenchyma. Anti-myelin oligodendrocyte glycoprotein antibody was elevated, while oligoclonal bands and anti-aquaporin 4 antibody were negative. The patient met the 2023 International Diagnostic Criteria for Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) and, concurrently, potentially fulfilled the 2013 International Pediatric Multiple Sclerosis Study Group criteria for paediatric multiple sclerosis (MS). The primary diagnosis was MOGAD, with paediatric MS considered as a possibility. Corticosteroid treatment improved vision, with no recurrence over 6 months without disease-modifying therapy. Both optic fundi showed atrophy 3 months after the acute phase, but the visual acuity was normal in both eyes, further raising the possibility of MOGAD over paediatric MS. This case highlights the diagnostic complexities in paediatric acute demyelinating syndromes, demonstrating potential overlap between MOGAD and MS diagnoses in children.
More Related Videos
05:55Author Spotlight: Novel Assay for Studying B-Cell Responses in Multiple Sclerosis Research
Published on: December 1, 2023
10:19High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum
Published on: November 23, 2013
