Detection of myelin oligodendrocyte glycoprotein antibody in pediatric patient with acute disseminated encephalomyelitis: a case report

Abstract

Introduction: Acute Disseminated Encephalomyelitis (ADEM) is an immunity-mediated central nervous system demyelinating disorder. Myelin Oligodendrocyte Glycoprotein (MOG) examination provides information about a patient's ADEM development status. A positive MOG antibody can signify a first episode or incomplete recovery. This review aims to report a case of a pediatric patient with acute disseminated encephalomyelitis with positive MOG antibody. Case Presentation: We present a 5-year-old girl with symptoms of low-grade fever, encephalopathy, blurred vision, numb and tingling sensations on hands and feet, weakness, unable to walk. Head MRI (Magnetic Resonance Imaging) examination reveals lesions in the bilateral thalamus and white matter of the left parietal lobe. There was also a bilateral thickening of the optic nerves. Blood laboratory examination was relatively normal, and the MOG antibody test was positive. The patient was then treated with corticosteroids for 1 year and had 2 recurrent episodes of attacks. MOG test evaluation was still also positive 6 months after the first attack. After Intravenous immunoglobulin (IVIG) treatment was given, resulting in excellent clinical response and no recurrent attack since then. Conclusions: ADEM cases have a good prognosis and good recovery. IVIG administration, with the help of other supportive therapy, improves recovery in treating pediatric ADEM.