TY - JOUR
T1 - Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection
T2 - A case report
AU - Nakamura, Yoshitsugu
AU - Nakajima, Hideto
AU - Tani, Hiroki
AU - Hosokawa, Takafumi
AU - Ishida, Shimon
AU - Kimura, Fumiharu
AU - Kaneko, Kimihiko
AU - Takahashi, Toshiyuki
AU - Nakashima, Ichiro
N1 - Funding Information:
This work was supported by JSPS KAKENHI, Grant Number 15 K45678, from the Ministry of Education, Culture, Sports, Science and Technology, Japan. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/4/19
Y1 - 2017/4/19
N2 - 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.
AB - 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.
KW - Acute disseminate encephalomyelitis
KW - Antecedent infection
KW - Case report
KW - Epstein-Barr virus
KW - Myelin oligodendrocyte glycoprotein
KW - Transverse myelitis
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U2 - 10.1186/s12883-017-0858-6
DO - 10.1186/s12883-017-0858-6
M3 - Article
C2 - 28420330
AN - SCOPUS:85018510355
SN - 1471-2377
VL - 17
JO - BMC Neurology
JF - BMC Neurology
IS - 1
M1 - 76
ER -