A case of anti-myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) associated disorder (MOGAD) with clinical manifestations of acute disseminated encephalomyelitis: Secondary to mycoplasma pneumoniae infection

Xiangui Huang; Rui Guo; Chunhong Li; Xingjiang Long; Tong Yang; Xianliang Hou; Xiaohong Wei; Minglin Ou

doi:10.1016/j.heliyon.2023.e13470

A case of anti-myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) associated disorder (MOGAD) with clinical manifestations of acute disseminated encephalomyelitis: Secondary to mycoplasma pneumoniae infection

Heliyon. 2023 Feb 4;9(2):e13470. doi: 10.1016/j.heliyon.2023.e13470. eCollection 2023 Feb.

Authors

Xiangui Huang¹, Rui Guo², Chunhong Li³, Xingjiang Long¹, Tong Yang¹, Xianliang Hou³, Xiaohong Wei¹, Minglin Ou³

Affiliations

¹ Department of Paediatrics, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, P. R. 545006, China.
² Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, P. R. 545006, China.
³ Central Laboratory, Guangxi Health Commission Key Laboratory of Glucose and Lipid Metabolism Disorders, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, P. R. 541199, China.

Abstract

Anti-myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) associated disorder (MOGAD) is an immune-mediated central nervous system (CNS) inflammatory demyelinating disorder that has been widely recognized in recent years. It is distinct from multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which are separate disease spectrums. Here we report the case of a 5-year-old boy who was admitted for 3 days with fever, headache, and vomiting. Magnetic resonance imaging revealed abnormal hyperintensity in the left thalamus and positive serum IgM for M. pneumoniae. After treatment with azithromycin, the headache gradually disappeared, but paralysis and urinary retention occurred on the 6th day after admission. MRI re-examination showed that the original abnormal signal in the left thalamus was significantly weakened, but new abnormal signals appeared in the brain and cerebrospinal cord, and the serum MOG-IgG was positive. After treatment, the child has fully recovered and is still receiving follow-up care. We believe that this is a case of MOGAD in a child with a biphasic ADEM phenotype secondary to M. pneumoniae infection, which has potential value in elucidating the pathophysiology of MOGAD.

Keywords: Acute disseminated encephalomyelitis; Anti-myelin oligodendrocyte glycoprotein-IgG associated disorders; CNS, central nervous system; Case report; Inflammatory demyelinating disease; M. pneumoniae infection; MOGAD, Anti-myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G associated disorders; MS, multiple sclerosis; NMOSD, neuromyelitis optica spectrum disorder; T2WI, T2 weighted images.

Publication types

Case Reports