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BMC Neurology
Published in: BMC Neurology 1/2017

Open Access 01-12-2017 | Case report

Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report

Authors: Yoshitsugu Nakamura, Hideto Nakajima, Hiroki Tani, Takafumi Hosokawa, Shimon Ishida, Fumiharu Kimura, Kimihiko Kaneko, Toshiyuki Takahashi, Ichiro Nakashima

Published in: BMC Neurology | Issue 1/2017

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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.
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Metadata
Title
Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report
Authors
Yoshitsugu Nakamura
Hideto Nakajima
Hiroki Tani
Takafumi Hosokawa
Shimon Ishida
Fumiharu Kimura
Kimihiko Kaneko
Toshiyuki Takahashi
Ichiro Nakashima
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2017
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-017-0858-6

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