Case of anti-myelin oligodendrocyte glycoprotein antibody-associated demyelinating disease with atopic dermatitis

Background: Anti-myelin oligodendrocyte glycoprotein (MOG) antibodies occur in a small group of neuromyelitis optica spectrum disorders. However, the clinical significance of this autoantibody has not been fully established. Case presentation: An 18-year-old woman with a history of depression and atopic disease developed left-side dominant diffuse muscle weakness and numbness with bilateral ankle pseudoclonus along with deterioration of atopic dermatitis, which suggested the possibility of central nerve system damage, although there were no abnormal findings on magnetic resonance imaging. During hospitalization, her neurological symptoms naturally improved, so a wait-and-see approach was chosen. After discharge, she developed temporal blurred vision, and then a modest elevation in anti-MOG antibodies (1:128) was observed. We subsequently diagnosed the patient with possible anti-MOG antibody-associated disease. After intravenous methylprednisolone therapy was started, her pseudoclonus and gait disturbance were improved. Conclusions: This case suggests that atopic dermatitis is possibly a trigger for developing anti-MOG antibody-associated disorder, and that some instances of possible central nerve system-demyelinating disease associated with anti-MOG antibodies could be poorly identifiable using magnetic resonance imaging. Anti-MOG antibody test might be worthwhile when a patient develops neurological symptoms without apparent magnetic resonance imaging lesions.