Srpski arhiv za celokupno lekarstvo 2022 Volume 150, Issue 3-4, Pages: 212-215
https://doi.org/10.2298/SARH211202024R
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Pediatric acute disseminated encephalomyelitis associated with myelin oligodendrocyte glycoprotein antibodies
Redžek-Mudrinić Tatjana 
(University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia), tatjana.redzek-mudrinic@mf.uns.ac.rs
Kavečan Ivana (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia)
Koprivšek Katarina (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia)
Rakić Goran (University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia)
Pajić Jasmina (Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia)
Introduction. Myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) are immunemediated inflammatory conditions of the central nervous system (CNS) with a wide clinical phenotypic variability. In order to further understand the possible phenotype of MOGAD here we report a pediatric case of acute disseminated encephalomyelitis (ADEM) associated with MOG antibodies. Case outline. A previously healthy four-month-old infant presented due to a 1-day history of fever up to 39°C and vomiting. On admission, she was encephalopathic. Repetitive and frequent stereotyped dystonic movements were observed. Cerebrospinal fluid (CSF) examination showed pleocytosis (lymphocytes were predominant) and proteinorachy. CSF culture and virology results were negative. Serum MOG antibodies were positive. A prolonged electroencephalography showed continuous high-amplitude slow rhythmic activity with captured stereotyped movement. Epileptic discharges were not seen. Although magnetic resonance imaging showed signs of acute demyelinating encephalomyelitis, our patient did not have seizures, despite neuroimaging findings of cortical lesions. Acute treatment with the corticosteroids led to excellent response with full recovery. Conclusion. This case emphasizes the inclusion of the MOG antibodies testing in the initial work-up in children presenting with acute encephalopathy associated with demyelinating or encephalitic abnormalities on brain and/or spinal magnetic resonance imaging even when the clinical phenotype is unusual. The prompt diagnosis of MOGAD is relevant for accurate disease monitoring and treatment strategies.
Keywords: MOG-antibody, ADEM, child, movement disorder
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