Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: A case report

Yoshitsugu Nakamura, Hideto Nakajima, Hiroki Tani, Takafumi Hosokawa, Shimon Ishida, Fumiharu Kimura, Kimihiko Kaneko, Toshiyuki Takahashi, Ichiro Nakashima

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22 Citations (Scopus)

Abstract

Background: Anti-Myelin oligodendrocyte glycoprotein (MOG) antibodies are detected in various demyelinating diseases, such as pediatric acute disseminated encephalomyelitis (ADEM), recurrent optic neuritis, and aquaporin-4 antibody-seronegative neuromyelitis optica spectrum disorder. We present a patient who developed anti-MOG antibody-positive ADEM following infectious mononucleosis (IM) due to Epstein-Barr virus (EBV) infection. Case presentation: A 36-year-old healthy man developed paresthesia of bilateral lower extremities and urinary retention 8days after the onset of IM due to primary EBV infection. The MRI revealed the lesions in the cervical spinal cord, the conus medullaris, and the internal capsule. An examination of the cerebrospinal fluid revealed pleocytosis. Cell-based immunoassays revealed positivity for anti-MOG antibody with a titer of 1:1024 and negativity for anti-aquaporin-4 antibody. His symptoms quickly improved after steroid pulse therapy followed by oral betamethasone. Anti-MOG antibody titer at the 6-month follow-up was negative. Conclusions: This case suggests that primary EBV infection would trigger anti-MOG antibody-positive ADEM. Adult ADEM patients can be positive for anti-MOG antibody, the titers of which correlate well with the neurological symptoms.

Original languageEnglish
Article number76
JournalBMC Neurology
Volume17
Issue number1
DOIs
Publication statusPublished - 2017 Apr 19

Keywords

  • Acute disseminate encephalomyelitis
  • Antecedent infection
  • Case report
  • Epstein-Barr virus
  • Myelin oligodendrocyte glycoprotein
  • Transverse myelitis

ASJC Scopus subject areas

  • Clinical Neurology

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