Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children
Background: Myelin oligodendrocyte glycoprotein antibody associated disease (MOG-AD) is an inflammatory disorder of the central nervous system, identified more frequently in children than adults. We report 4 children with MOG-AD. Clinical Description: Cases 1–3 presented with fever, headache, and vo...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Indian Pediatrics Case Reports |
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| Online Access: | https://journals.lww.com/10.4103/ipcares.ipcares_116_24 |
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| author | Vinothini Venkatachalam Ayyammal Palaniappan Ramakrishanan Tirupur Chinnappan Ramalingam Srimathi Gopalakrishnan Antony Terance Benjamin Anupama Maheswaran |
| author_facet | Vinothini Venkatachalam Ayyammal Palaniappan Ramakrishanan Tirupur Chinnappan Ramalingam Srimathi Gopalakrishnan Antony Terance Benjamin Anupama Maheswaran |
| author_sort | Vinothini Venkatachalam |
| collection | DOAJ |
| description | Background:
Myelin oligodendrocyte glycoprotein antibody associated disease (MOG-AD) is an inflammatory disorder of the central nervous system, identified more frequently in children than adults. We report 4 children with MOG-AD.
Clinical Description:
Cases 1–3 presented with fever, headache, and vomiting for varying durations. Case 4 presented with acute-onset impaired vision, after a prior episode of meningoencephalitis-like picture. Examination showed that Cases 1 and 2 had neck rigidity, and Case 4 had papilledema along with reduced visual acuity. Other cranial nerves, power, tone, and reflexes were normal in all children.
Management and Outcome:
Laboratory investigations were largely normal except elevated total leukocyte count and C-reactive protein in Cases 1 and 3 with a marginal rise in C- reactive protein in Cases 2 and 4. Cerebrospinal analysis showed pleocytosis with lymphocytic predominance and increased protein in Cases 3 and 4. Magnetic resonance imaging revealed features consistent with meningoencephalitis in Cases 1 and 3, acute disseminated encephalomyelitis in Case 2, and optic neuritis in Case 4. All the children had positive titers of anti-MOG, thus being diagnosed as MOG-AD. All the children were treated with intravenous methylprednisolone with a few of them requiring additional immunomodulator therapy. All the cases showed excellent recovery and remained in remission till the last follow-up.
Conclusion:
Children presenting with features simulating meningoencephalitis may be due to the rare condition of MOG-AD. A knowledge about this condition and specific investigations with expert interpretation and specific treatment can result in favorable outcomes. |
| format | Article |
| id | doaj-art-bdd71056bd404feeb8ecf9057416c5ee |
| institution | Kabale University |
| issn | 2772-5170 2772-5189 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Pediatrics Case Reports |
| spelling | doaj-art-bdd71056bd404feeb8ecf9057416c5ee2024-12-10T08:52:01ZengWolters Kluwer Medknow PublicationsIndian Pediatrics Case Reports2772-51702772-51892024-11-014420420910.4103/ipcares.ipcares_116_24Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four ChildrenVinothini VenkatachalamAyyammal PalaniappanRamakrishanan Tirupur Chinnappan RamalingamSrimathi GopalakrishnanAntony Terance BenjaminAnupama MaheswaranBackground: Myelin oligodendrocyte glycoprotein antibody associated disease (MOG-AD) is an inflammatory disorder of the central nervous system, identified more frequently in children than adults. We report 4 children with MOG-AD. Clinical Description: Cases 1–3 presented with fever, headache, and vomiting for varying durations. Case 4 presented with acute-onset impaired vision, after a prior episode of meningoencephalitis-like picture. Examination showed that Cases 1 and 2 had neck rigidity, and Case 4 had papilledema along with reduced visual acuity. Other cranial nerves, power, tone, and reflexes were normal in all children. Management and Outcome: Laboratory investigations were largely normal except elevated total leukocyte count and C-reactive protein in Cases 1 and 3 with a marginal rise in C- reactive protein in Cases 2 and 4. Cerebrospinal analysis showed pleocytosis with lymphocytic predominance and increased protein in Cases 3 and 4. Magnetic resonance imaging revealed features consistent with meningoencephalitis in Cases 1 and 3, acute disseminated encephalomyelitis in Case 2, and optic neuritis in Case 4. All the children had positive titers of anti-MOG, thus being diagnosed as MOG-AD. All the children were treated with intravenous methylprednisolone with a few of them requiring additional immunomodulator therapy. All the cases showed excellent recovery and remained in remission till the last follow-up. Conclusion: Children presenting with features simulating meningoencephalitis may be due to the rare condition of MOG-AD. A knowledge about this condition and specific investigations with expert interpretation and specific treatment can result in favorable outcomes.https://journals.lww.com/10.4103/ipcares.ipcares_116_24demyelinating disorderimmunomodulationinflammatory disorderoptic neuritis |
| spellingShingle | Vinothini Venkatachalam Ayyammal Palaniappan Ramakrishanan Tirupur Chinnappan Ramalingam Srimathi Gopalakrishnan Antony Terance Benjamin Anupama Maheswaran Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children Indian Pediatrics Case Reports demyelinating disorder immunomodulation inflammatory disorder optic neuritis |
| title | Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children |
| title_full | Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children |
| title_fullStr | Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children |
| title_full_unstemmed | Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children |
| title_short | Rare Presentation of Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease in Four Children |
| title_sort | rare presentation of myelin oligodendrocyte glycoprotein antibody associated disease in four children |
| topic | demyelinating disorder immunomodulation inflammatory disorder optic neuritis |
| url | https://journals.lww.com/10.4103/ipcares.ipcares_116_24 |
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