Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes

BackgroundMyelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases (MOGAD), which has been recognized as a distinct entity in patients with neuromyelitis optica spectrum disorders, often presents with acute disseminated encephalomyelitis (ADEM) symptoms in pediatric patients. Appropria...

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Main Authors: Masayuki Tahara, Tomonari Awaya, Keisuke Saito, Hideyuki Sawada
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1551379/full
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author Masayuki Tahara
Tomonari Awaya
Tomonari Awaya
Keisuke Saito
Hideyuki Sawada
author_facet Masayuki Tahara
Tomonari Awaya
Tomonari Awaya
Keisuke Saito
Hideyuki Sawada
author_sort Masayuki Tahara
collection DOAJ
description BackgroundMyelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases (MOGAD), which has been recognized as a distinct entity in patients with neuromyelitis optica spectrum disorders, often presents with acute disseminated encephalomyelitis (ADEM) symptoms in pediatric patients. Appropriate treatment based on accurate diagnosis is challenging in relapsing pediatric patients with MOGAD.Case PresentationAn 11-year-old girl experienced relapses four times, exhibiting brainstem symptoms, an ADEM episode, seizures, and optic neuritis (ON). She was initially diagnosed with multiple sclerosis and received interferon beta-1a therapy with a mild effect on relapse suppression. She was then transferred from the pediatric department to the department of neurology of our hospital. Two months before her referral visit, she experienced left optic neuritis, and her annualized relapse rate reached 0.6. She desired to switch from the injectable treatment to oral dimethyl fumarate (DMF) administration. At that time, she was found to be seropositive for MOG antibody, but after that had no relapses for more than five years. Moreover, her seropositivity for serum MOG-antibody turned out to be seronegative.ConclusionsDMF showed long-term effects on suppressing relapses in a pediatric patient with MOGAD, revealing its potential as a treatment option for such patients.
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spelling doaj-art-da9a809b7b6c4f98864822f0323ba1ae2025-08-20T03:11:06ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-02-011610.3389/fimmu.2025.15513791551379Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodesMasayuki Tahara0Tomonari Awaya1Tomonari Awaya2Keisuke Saito3Hideyuki Sawada4Department of Neurology, National Hospital Organization Utano National Hospital, Kyoto, JapanDepartment of Anatomy and Developmental Biology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Neurology, National Hospital Organization Utano National Hospital, Kyoto, JapanDepartment of Neurology, National Hospital Organization Utano National Hospital, Kyoto, JapanBackgroundMyelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases (MOGAD), which has been recognized as a distinct entity in patients with neuromyelitis optica spectrum disorders, often presents with acute disseminated encephalomyelitis (ADEM) symptoms in pediatric patients. Appropriate treatment based on accurate diagnosis is challenging in relapsing pediatric patients with MOGAD.Case PresentationAn 11-year-old girl experienced relapses four times, exhibiting brainstem symptoms, an ADEM episode, seizures, and optic neuritis (ON). She was initially diagnosed with multiple sclerosis and received interferon beta-1a therapy with a mild effect on relapse suppression. She was then transferred from the pediatric department to the department of neurology of our hospital. Two months before her referral visit, she experienced left optic neuritis, and her annualized relapse rate reached 0.6. She desired to switch from the injectable treatment to oral dimethyl fumarate (DMF) administration. At that time, she was found to be seropositive for MOG antibody, but after that had no relapses for more than five years. Moreover, her seropositivity for serum MOG-antibody turned out to be seronegative.ConclusionsDMF showed long-term effects on suppressing relapses in a pediatric patient with MOGAD, revealing its potential as a treatment option for such patients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1551379/fullmyelin oligodendrocyte glycoprotein antibody-associated diseasedimethyl fumarateacute disseminated encephalomyelitisoptic neuritisseizure
spellingShingle Masayuki Tahara
Tomonari Awaya
Tomonari Awaya
Keisuke Saito
Hideyuki Sawada
Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes
Frontiers in Immunology
myelin oligodendrocyte glycoprotein antibody-associated disease
dimethyl fumarate
acute disseminated encephalomyelitis
optic neuritis
seizure
title Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes
title_full Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes
title_fullStr Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes
title_full_unstemmed Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes
title_short Case Report: Long-term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody–associated disease manifesting as acute disseminated encephalomyelitis, unilateral optic neuritis, and seizure episodes
title_sort case report long term suppression of relapses by dimethyl fumarate in a relapsing pediatric patient with myelin oligodendrocyte glycoprotein antibody associated disease manifesting as acute disseminated encephalomyelitis unilateral optic neuritis and seizure episodes
topic myelin oligodendrocyte glycoprotein antibody-associated disease
dimethyl fumarate
acute disseminated encephalomyelitis
optic neuritis
seizure
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1551379/full
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