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Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report.
BMC Neurol. 2017 Apr 19; 17(1):76.BN

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 8 days 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.

Authors+Show Affiliations

Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan. in1394@osaka-med.ac.jp.Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan.Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan.Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan.Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan.Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan.Division of Neurology, Tohoku University School of Medicine, Seiryomachi 1-1, Aobaku, Sendai, 980-8574, Japan.Division of Neurology, NHO Yonezawa Hospital, Ozimisawa 26100-1, Yonezawashi, Yamagata, 992-1202, Japan.Division of Neurology, Tohoku University School of Medicine, Seiryomachi 1-1, Aobaku, Sendai, 980-8574, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28420330

Citation

Nakamura, Yoshitsugu, et al. "Anti-MOG Antibody-positive ADEM Following Infectious Mononucleosis Due to a Primary EBV Infection: a Case Report." BMC Neurology, vol. 17, no. 1, 2017, p. 76.
Nakamura Y, Nakajima H, Tani H, et al. Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report. BMC Neurol. 2017;17(1):76.
Nakamura, Y., Nakajima, H., Tani, H., Hosokawa, T., Ishida, S., Kimura, F., Kaneko, K., Takahashi, T., & Nakashima, I. (2017). Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report. BMC Neurology, 17(1), 76. https://doi.org/10.1186/s12883-017-0858-6
Nakamura Y, et al. Anti-MOG Antibody-positive ADEM Following Infectious Mononucleosis Due to a Primary EBV Infection: a Case Report. BMC Neurol. 2017 Apr 19;17(1):76. PubMed PMID: 28420330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: 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, Y1 - 2017/04/19/ PY - 2016/12/21/received PY - 2017/04/11/accepted PY - 2017/4/20/entrez PY - 2017/4/20/pubmed PY - 2017/5/17/medline KW - Acute disseminate encephalomyelitis KW - Antecedent infection KW - Case report KW - Epstein–Barr virus KW - Myelin oligodendrocyte glycoprotein KW - Transverse myelitis SP - 76 EP - 76 JF - BMC neurology JO - BMC Neurol VL - 17 IS - 1 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 8 days 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. SN - 1471-2377 UR - https://www.unboundmedicine.com/medline/citation/28420330/Anti_MOG_antibody_positive_ADEM_following_infectious_mononucleosis_due_to_a_primary_EBV_infection:_a_case_report_ L2 - https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-017-0858-6 DB - PRIME DP - Unbound Medicine ER -