A Case Report of Pediatric Mog- Antibody Disease With Bilateral Optic Neuritis

Abstract

MOG – Antibody disease is an inflammatory demyelinating condition of the CNS characterized by a monophasic or relapsing course of neurological dysfunction which does not meet the typical criteria for multiple sclerosis or other known neuro inflammatory conditions and occurs in presence of serum MOG antibodies using specific cell based assays. In pediatric patients MOG antibodies are detected in range of relapsing phenotypes including relapsing inflammatory optic neuritis (RION), acute disseminated encephalomyelitis followed by optic neuritis (ADEM – ON), brain stem demyelination and aquaporin P4 antibody negative neuromyelitis optica spectrum disorder (AQP4-Ab negative NMOSD).MOG positive optic neuritis is frequently bilateral and associated with optic nerve head swelling.It is associated with neurological diseases like Multiple Sclerosis, ADEM or Transverse Myelitis.MOG antibody IgG is detected in serum by indirect fluorescence test.IV Methylprednisolone is the treatment of choice, if it fails to improve vision or if optic neuritis is recurring, then a combination of plasma exchange and IV Methylprednisolone should be considered.Long term immunosuppressants used for Prevention include corticosteroids, azathioprine, mycophenolate mofetil and rituximab. The optimal preventive therapy has yet to be determined.Once the disease has been diagnosed, uncertainty remains over the best treatment approach and clinical trials for the pharmacological management of MOG- antibody optic neuritis are still needed.