Aseptic meningitis as an atypical manifestation of neuromyelitis optica spectrum disorder flare

Shi, Bingxin; Jiang, Wei; He, Mianwang; Sun, Hui; Sun, Xuan; Yang, Yang; Yao, Jiarui; Wu, Lei; Huang, Dehui

doi:10.1016/j.msard.2020.102013

Cited by 18 publications

(7 citation statements)

References 18 publications

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“…Ten cases of aseptic meningitis associated with MOG antibodies in seven published studies were included in our analysis (Ji et al, 2021;Lampros et al, 2021;Patterson et al, 2019;Shi et al, 2020;Song et al, 2022;Udani et al, 2021;Zhang et al, 2021). The clinical characteristics of the 12 patients (including the two cases reported in this study) are listed in including 6 patients receiving sequential oral prednisone, while no details were obtained from the other 4 patients).…”

Section: Resultsmentioning

confidence: 99%

“…In the present study, we report the cases of two children with MOGAM and systematically review 10 cases in the literature, focusing on clinical features and related risk factors. The imaging manifestations of different phenotypes of MOGAD are diverse, including the white matter, cortex, subcortical white matter, optic nerve, deep nucleus (thalamus, basal ganglia), brainstem, and long or short spinal segments (Cobo-Calvo et al, 2018;Shor et al, 2021). MOG-related encephalitis is the most common autoimmune encephalitis in children, accounting for 34% of all cases of autoimmune encephalitis except ADEM (Armangue et al, 2014), which further expands the spectrum of MOGAD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Myelin oligodendrocyte glycoprotein antibody-associated aseptic meningitis without neurological parenchymal lesions: A novel phenotype

Lin

Long

Wen

et al. 2022

Multiple Sclerosis and Related Disorders

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Myelin oligodendrocyte glycoprotein antibody-associated aseptic meningitis without neurological parenchymal lesions: A novel phenotype

Lin

Long

Wen

et al. 2022

Multiple Sclerosis and Related Disorders

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“…These symptoms were so similar to those of infectious meningomyelitis that left the diagnosis process in dilemma. However, previous reports showed that the lack of improvement in empiric antibiotic or anti-tuberculosis therapy favored the NMOSD attack ( 6 , 8 ). Some patients were not correctly diagnosed at the first hospitalization but were further diagnosed when they relapsed during the follow-up ( 6 ).…”

Section: Discussionmentioning

confidence: 97%

“…We reviewed the previous literature and summarized the characteristics of the reported cases of NMOSD with seropositive AQP4 antibodies who presented with meningitis/meningomyelitis-like symptoms in the first attack ( Table 1 ) ( 6 – 8 ). All patients had infection-like manifestations such as fever or headache in their early stages, along or subsequent with core symptoms of NMOSD.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Neuromyelitis Optica Spectrum Disorder With Progressive Elevation of Cerebrospinal Fluid Cell Count and Protein Level Mimicking Infectious Meningomyelitis: A Diagnostic Challenge

Zhang

Cai

et al. 2022

Front. Immunol.

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Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune-mediated idiopathic inflammatory demyelinating disease with a typical clinical presentation of optic neuritis, acute myelitis, and area postrema syndrome. Most NMOSD patients are seropositive for disease-specific and pathogenic aquaporin-4 (AQP4) antibodies, which are key markers for the NMOSD diagnosis. Herein, we report an atypical case of a 41-year-old man who complained of intractable hiccups and vomiting at disease onset, followed by fever, headache, back pain, progressive paresthesia, and weakness of extremities later on. Magnetic resonance imaging revealed longitudinally extensive transverse myelitis. Cerebrospinal fluid analysis showed progressive increases in the white blood cell count and the protein level, which were accompanied by the deterioration of clinical manifestations. The patient was initially suspected of infectious meningomyelitis but was finally diagnosed with NMOSD. This case with distinct cerebrospinal fluid findings broadens the phenotypic spectrum of NMOSD. Furthermore, it also highlights the clinical value of AQP4 antibody test for early definitive diagnosis and proper treatment.

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“…Currently, approximately 11 aseptic meningitis cases accompanied by MOGAD have been reported ( Narayan et al, 2019 ; Suzuki et al, 2019 ; Leinert et al, 2020 ; Miller et al, 2020 ; Shi et al, 2020 ; Shen et al, 2021 ; Vibha et al, 2021 ; Zhang et al, 2021 ). Headache, fever, and ON were the most common symptoms, with mildly higher CSF cells, except in one case (1335/dL) ( Miller et al, 2020 ).…”

Section: Othermentioning

confidence: 99%

Clinical Features and Imaging Findings of Myelin Oligodendrocyte Glycoprotein-IgG-Associated Disorder (MOGAD)

Liu

Wang

et al. 2022

Front. Aging Neurosci.

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Myelin oligodendrocyte glycoprotein-IgG-associated disorder (MOGAD) is a nervous system (NS) demyelination disease and a newly recognized distinct disease complicated with various diseases or symptoms; however, MOGAD was once considered a subset of neuromyelitis optica spectrum disorder (NMOSD). The detection of MOG-IgG has been greatly improved by the cell-based assay test method. In one study, 31% of NMOSD patients with negative aquaporin-4 (AQP-4) antibody were MOG-IgG positive. MOGAD occurs in approximately the fourth decade of a person’s life without a markedly female predominance. Usually, optic neuritis (ON), myelitis or acute disseminated encephalomyelitis (ADEM) encephalitis are the typical symptoms of MOGAD. MOG-IgG have been found in patients with peripheral neuropathy, teratoma, COVID-19 pneumonia, etc. Some studies have revealed the presence of brainstem lesions, encephalopathy or cortical encephalitis. Attention should be given to screening patients with atypical symptoms. Compared to NMOSD, MOGAD generally responds well to immunotherapy and has a good functional prognosis. Approximately 44-83% of patients undergo relapsing episodes within 8 months, which mostly involve the optic nerve, and persistently observed MOG-IgG and severe clinical performance may indicate a polyphasic course of illness. Currently, there is a lack of clinical randomized controlled trials on the treatment and prognosis of MOGAD. The purpose of this review is to discuss the clinical manifestations, imaging features, outcomes and prognosis of MOGAD.

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Aseptic meningitis as an atypical manifestation of neuromyelitis optica spectrum disorder flare

Cited by 18 publications

References 18 publications

Myelin oligodendrocyte glycoprotein antibody-associated aseptic meningitis without neurological parenchymal lesions: A novel phenotype

Myelin oligodendrocyte glycoprotein antibody-associated aseptic meningitis without neurological parenchymal lesions: A novel phenotype

Case Report: Neuromyelitis Optica Spectrum Disorder With Progressive Elevation of Cerebrospinal Fluid Cell Count and Protein Level Mimicking Infectious Meningomyelitis: A Diagnostic Challenge

Clinical Features and Imaging Findings of Myelin Oligodendrocyte Glycoprotein-IgG-Associated Disorder (MOGAD)

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