Anti-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Meningitis with Psychotic Symptoms

Abstract

Introduction: Anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated encephalitis is a demyelinating central nervous system disease, whose most common clinical manifestations are optic neuritis, myelitis and acute disseminated encephalitis. However, data on psychotic symptoms in anti-MOG antibody-associated meningitis are still limited. Case description: A 31-year-old female presented with headache, fever, thinking rupture, and dissociative amnesia. Enhancement of the pia mater was found in her magnetic resonance imaging. With antiviral therapies and anti-psychotic treatment, her symptoms didn’t disappear until positive anti-MOG IgG antibody was found in the serum and she received steroid therapy. Conclusion: Psychotic symptoms may be the main manifestation of anti-MOG antibody-associated meningitis. Besides being caused by anti-neuronal antibodies against cell-surface antigens (such as anti-N-methyl-D-aspartate receptor antibodies) and intracellular antigens (such as anti-Hu antibodies), autoimmune psychosis could also occur due to anti-myelin antibodies against MOG. These findings may expand the understanding of this newly described autoimmune disease.