MOG-Ab titer-guided approach for steroid tapering to prevent relapse in children with mog antibody-associated adem diseases: A case report

Koyuru Kurane; Yukifumi Monden; Daisuke Tanaka; Yuji Gunji; Takahiro Ikeda; Akihiko Miyauchi; Hitoshi Osaka; Toshiyuki Takahashi; Takanori Yamagata

doi:10.1016/j.msard.2020.102320

MOG-Ab titer-guided approach for steroid tapering to prevent relapse in children with mog antibody-associated adem diseases: A case report

Mult Scler Relat Disord. 2020 Oct:45:102320. doi: 10.1016/j.msard.2020.102320. Epub 2020 Jun 20.

Authors

Koyuru Kurane¹, Yukifumi Monden², Daisuke Tanaka¹, Yuji Gunji³, Takahiro Ikeda¹, Akihiko Miyauchi⁴, Hitoshi Osaka¹, Toshiyuki Takahashi⁵, Takanori Yamagata¹

Affiliations

¹ Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotuke-city, Tochigi, Japan.
² Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotuke-city, Tochigi, Japan; Department of Pediatrics, International University of Health and Welfare, 537-3 Iguchi, Nasushiobara-city, Tochigi, Japan. Electronic address: mon4441977319@jichi.ac.jp.
³ Department of Pediatrics, International University of Health and Welfare, 537-3 Iguchi, Nasushiobara-city, Tochigi, Japan.
⁴ Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotuke-city, Tochigi, Japan; Tochigi Prefectural Rehabilitation Center, 3337-1 Komanyumachi, Ustunomiya-city, Tochigi, Japan.
⁵ Department of Neurology, Tohoku University Graduate School of Medicine, 2-1 Seiryoumachi, Aoba-ku, Sendai, Miyagi, Japan; Department of Neurology, National Hospital Organization Yonezawa National Hospital, 6-36 Aioicho, Yonezawa-city, Yamagata, Japan.

PMID: 32622298
DOI: 10.1016/j.msard.2020.102320

Abstract

Intravenous corticosteroids have been regarded as the first-line therapy of anti-myelin-oligodendrocyte glycoprotein antibody (MOG-Ab)-positive acute disseminated encephalomyelitis (ADEM). While steroids are the first-choice therapy, MOG-Ab-positive ADEM has a high relapse rate. In some cases, MOG-Ab-positive ADEM relapses even in a low-MOG-Abs state. There is no evidence-based rule supporting steroid tapering. We herein report a case of MOG-Ab-positive ADEM in which recurrence was preventing by tapering steroids under MOG-Ab seronegativity confirmation. In some cases, the MOG-Ab titer may be an important index for tapering steroids to prevent relapse.

Keywords: Acute disseminated encephalomyelitis; Demyelination; Multiple sclerosis; Myelin oligodendrocyte glycoprotein; Optic neuritis; Rituximab.

Publication types

Case Reports

MeSH terms

Autoantibodies*
Child
Encephalomyelitis, Acute Disseminated* / drug therapy
Humans
Myelin-Oligodendrocyte Glycoprotein
Recurrence
Steroids

Substances

Autoantibodies
Myelin-Oligodendrocyte Glycoprotein
Steroids