Manifestations of Myelinating Oligodendrocyte Glycoprotein Antibody-Associated Disease: A Rare Case of Suppurative Meningoencephalitis

Abstract

Myelinating oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system (CNS) mediated by MOG antibodies (MOG-IgG). It is associated with autoimmunity and encompasses various syndromes. However, manifestations presenting with symptoms of suppurative meningoencephalitis are rare. In this case, we admitted an 80-year-old male patient who presented with fever, headache, mental and behavioral abnormalities, and disturbance of consciousness. The cerebrospinal fluid (CSF) examination revealed elevated levels of leukocytes and protein, while magnetic resonance imaging (MRI) of the brain showed an abnormal signal in the parietal lobe surrounding the posterior horn of the right lateral ventricle. The patient tested positive for serum MOG-IgG, confirming the diagnosis of MOG-IgG-related meningoencephalitis. The treatment included intravenous immunoglobulin, glucocorticoids, third-generation cephalosporins, and immunosuppressants. Following the treatment, the patient experienced complete recovery.