Skip to main content Skip to main navigation menu Skip to site footer

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

  • Valentina Nicolas ,
  • Prastiya Indra Gunawan ,
  • Riza Noviandi ,
  • Sunny Mariana Samosir ,


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.

Keywords: ADEM MOG Myelin Oligodendrocyte Glycoprotein Pediatric

References

  1. Brilot F, Dale RC, Selter RC, Grummel V, Reddy Kalluri S, Aslam M, et al. Antibodies to native myelin oligodendrocyte glycoprotein in children with inflammatory demyelinating central nervous system disease. Ann Neurol. 2009;66(6):833–42. doi: 10.1002/ana.21916.
  2. Izzawa K, Irsalina P, Haryono Y. Acute Disseminated Encephalomyelitis (ADEM) in Adult Women, Is it Unpreceded by Infection History?: A Case Report. Int J Res Rev. 20218;8(10):21–7. doi:10.52403/ijrr.20211004.
  3. İncecik F, Hergüner MO, Altunbaşak S. Acute disseminated encephalomyelitis: an evaluation of 15 cases in childhood. Turk J Pediatr. 2013;55:253–9.
  4. Elhassanien A, Aziz H. Acute demyelinating encephalomyelitis: Clinical characteristics and outcome. J Pediatr Neurosci. 2013;8(1):26. doi:10.4103/1817-1745.1114185.
  5. Absoud M, Lim MJ, Chong WK, De Goede CG, Foster K, Gunny R, et al. Paediatric acquired demyelinating syndromes: incidence, clinical and magnetic resonance imaging features. Mult Scler J. 2013;19;19(1):76–86. doi:10.1177/1352458512445944.
  6. Pohl D, Alper G, Van Haren K, Kornberg AJ, Lucchinetti CF, Tenembaum S, et al. Acute disseminated encephalomyelitis: updates on an inflammatory cns syndrome. Neurology. 2016;87(9):S38–45.
  7. Baumann M, Sahin K, Lechner C, Hennes EM, Schanda K, Mader S, et al. Clinical and neuroradiological differences of paediatric acute disseminating encephalomyelitis with and without antibodies to the myelin oligodendrocyte glycoprotein. J Neurol Neurosurg Psychiatry. 2014;86(3):265–72.
  8. Arantrinita A, Lukisiari A. Successful Management of Isolated Optic Neuritis in Acute Diseminated Encephalomyelitis: A Case Report. Ann Mechnikov’s Inst. 2021;1:56–8.
  9. Pratamastuti D, Indra Gunawan P, Saharso D. Serum neuron specific enolase is increased in pediatric acute encephalitis syndrome. Korean J Pediatr. 2017;60(9):302. doi:10.3345/kjp.2017.60.9.302.
  10. Benítez-Marín MJ, Marín-Clavijo J, Blanco-Elena JA, Jiménez-López J, González-Mesa E. Brain Sparing Effect on Neurodevelopment in Children with Intrauterine Growth Restriction: A Systematic Review. Children. 2021 Jan;8(9):745.
  11. Hacohen Y, Absoud M, Deiva K, Hemingway C, Nytrova P, Woodhall M, et al. Myelin oligodendrocyte glycoprotein antibodies are associated with a non-MS course in children. Neurol - Neuroimmunol Neuroinflammation. 2015;12;2(2):e81. doi:10.1212/NXI.0000000000000081.
  12. Polat İ, Yiş U, Karaoğlu P, Ayanoğlu M, Öztürk T, Güleryüz H, et al. Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case. Pediatrics. 2016;1;137(5). doi:10.1542/peds.2015-1958.
  13. Marin SE, Callen DJA. The Magnetic Resonance Imaging Appearance of Monophasic Acute Disseminated Encephalomyelitis. Neuroimaging Clin N Am. 2013;23(2):245–66. Available from: doi:10.1016/j.nic.2012.12.005.
  14. Alexander M, Murthy JMK. Acute disseminated encephalomyelitis: Treatment guidelines. Ann Indian Acad Neurol. 2011;14(5):60. doi:10.4103/0972-2327.83095.
  15. Anggraini ND, Gunawan PI, Saharso D, Irwanto. A comparison of glutamic acid decarboxylase serum autoantibody levels in pediatric intractable and non-intractable epilepsy. Med Clínica Práctica. 2021;4:100237. doi:10.1016/j.mcpsp.2021.100237.

How to Cite

Nicolas, V., Prastiya Indra Gunawan, Riza Noviandi, & Samosir, S. M. (2022). Detection of myelin oligodendrocyte glycoprotein antibody in pediatric patient with acute disseminated encephalomyelitis: a case report. Bali Medical Journal, 11(3), 1591–1593. https://doi.org/10.15562/bmj.v11i3.3891
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
4

Share

Search Panel

Valentina Nicolas
Google Scholar
Pubmed
BMJ Journal

Prastiya Indra Gunawan
Google Scholar
Pubmed
BMJ Journal

Riza Noviandi
Google Scholar
Pubmed
BMJ Journal

Sunny Mariana Samosir
Google Scholar
Pubmed
BMJ Journal