Myelin oligodendrocyte glycoprotein antibody-associated disease is a demyelinating disorder affecting the central nervous system. Autoimmune regulator mutations disrupt central tolerance and cause immunodeficiency and autoimmune manifestations. We report the case of a 49-year-old Asian male with relapsing myelin oligodendrocyte glycoprotein antibody-associated disease and a heterozygous dominant-negative autoimmune regulator mutation (c.901G > A, p.Val301Met), alongside vitiligo, cryptococcal disease and nasopharyngeal carcinoma. This case raises a potential link between negative selection failure and myelin oligodendrocyte glycoprotein antibody-associated disease and suggests that autoreactive T cells may be primary pathogenetic drivers, implying that restoring immune tolerance could inform future therapeutic approaches.

Kabuki syndrome, caused by KMT2D or KDM6A mutations, is a multisystem disorder with immune dysregulation. Its association with aquaporin-4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder has not been reported. A 17-year-old male with autoimmune hypothyroidism presented with acute visual loss and was diagnosed with AQP4-IgG-positive optic neuritis. He received corticosteroids, plasma exchange, and rituximab, achieving full recovery and remaining relapse-free during follow-up. Genetic testing showed a likely pathogenic KMT2D variant. This case documents the first association between these conditions, where immune dysregulation, including FOXP3-dependent regulatory T-cell dysfunction and Th17-skewed inflammation, suggests a mechanistic link with implications for diagnosis and management.

There is an increasing number of people experiencing housing insecurity and forcible displacement globally. We perform a scoping review, searching PubMed (1 January 1990-30 June 2026) for the key terms "housing insecurity," "inadequate housing," "houselessness," "homelessness," "housing," "forcible displacement," "refugee," "asylum seeker," and "internal displacement," focusing on the outcomes of persons with multiple sclerosis. We estimate the approximate number of persons with multiple sclerosis in these situations. The number of reports from persons with multiple sclerosis who experience housing insecurity, homelessness, or forcible displacement remains very limited compared to the high number of estimated persons with multiple sclerosis living in these circumstances. Among US veterans, homelessness was not significantly more common among those with multiple sclerosis than matched veterans without multiple sclerosis. Refugees with multiple sclerosis experience inaffordability of care. A larger, but distinct, literature examining exposure to armed conflict (war) finds increased relapse and magnetic resonance imaging disease activity in subsets of persons with multiple sclerosis during conflict as well as disruptions in access to multiple sclerosis care and treatment. Global geographic representation of these reports is limited. We recommend health systems-based and clinical approaches for persons with multiple sclerosis in times of vulnerability. More data are needed to understand the defined risks to persons with multiple sclerosis as well as inform and monitor a durable humanitarian approach to their care.

Optic neuritis, a common manifestation of multiple sclerosis, involves acute axonal injury and variable visual recovery. We evaluated whether serum neurofilament light chain predicts visual and structural outcomes after first-episode optic neuritis. Fifty-one patients (mean age = 33 years, 71% women) were followed for 24 ± 6 months with low-contrast letter acuity testing and optical coherence tomography. Adjusting for age and sex, higher baseline serum neurofilament light chain predicted greater inter-eye differences in retinal nerve fibre layer (-4.65 µm per SD, p = 0.02), ganglion cell/inner plexiform layer (-1.39 µm, p = 0.02) and 2.5% low-contrast letter acuity (-0.73, p = 0.05), but not high-contrast acuity. Early serum neurofilament light chain may stratify optic neuritis severity and guide neuroprotective trial selection.