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BMC Neurology
Published in: BMC Neurology 1/2018

Open Access 01-12-2018 | Case report

Rebound of relapses after discontinuation of rituximab in a patient with MOG-IgG1 positive highly relapsing optic neuritis: a case report

Authors: Seok-Jin Choi, Boram Kim, Haeng-Jin Lee, Seong-Joon Kim, Sung-Min Kim, Jung-Joon Sung

Published in: BMC Neurology | Issue 1/2018

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Abstract

Background

Myelin oligodendrocyte glycoprotein immunoglobulin G1 (MOG-IgG1)-associated disease is suggested as a separate disease entity distinct from multiple sclerosis and neuromyelitis optica spectrum disorder. Nonetheless, the optimal treatment regimen for preventing relapses in MOG-IgG1-associated disease remains unclear.

Case presentation

We describe the case of a 45-year-old man with MOG-IgG1-positive highly relapsing optic neuritis who had experienced 5 attacks over 21 months and had monocular blindness despite prednisolone and azathioprine therapy. He began treatment with rituximab, which reduced the rate of relapse markedly. Following discontinuation of rituximab, however, the patient experienced two successive optic neuritis attacks 2 and 4 months after B-lymphocyte restoration.

Conclusions

Highly relapsing MOG-IgG1-associated disease can be prevented with rituximab even when the MOG-IgG1 titers are relatively stationary. Discontinuation of rituximab and restoration of B-lymphocytes may be associated with the rebound of disease activity.
Literature
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Jurynczyk M, Messina S, Woodhall MR, Raza N, Everett R, Roca-Fernandez A, Tackley G, Hamid S, Sheard A, Reynolds G, et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study. Brain. 2017;140(12):3128-38.
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Kim SM, Park J, Kim SH, Park SY, Kim JY, Sung JJ, Park KS, Lee KW. Factors associated with the time to next attack in neuromyelitis optica: accelerated failure time models with random effects. PLoS One. 2013;8(12):e82325.
Metadata
Title
Rebound of relapses after discontinuation of rituximab in a patient with MOG-IgG1 positive highly relapsing optic neuritis: a case report
Authors
Seok-Jin Choi
Boram Kim
Haeng-Jin Lee
Seong-Joon Kim
Sung-Min Kim
Jung-Joon Sung
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2018
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-018-1222-1

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