Abstract
BackgroundMyelin 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 presentationWe 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.ConclusionsHighly 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.
Highlights
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
Highly relapsing myelin oligodendrocyte glycoprotein (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
Summary
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. * Correspondence: sueh916@gmail.com 2Department of Neurology, Seoul National University Hospital, 101, Daehak-Ro Jongno-Gu, Seoul 03080, Republic of Korea Full list of author information is available at the end of the article relapses in patients with MOG-IgG1-associated disease has only recently begun to be studied [4]. We describe a patient with highly relapsing optic neuritis (ON) associated with MOG-IgG1, whose ON attacks were relatively well-prevented with rituximab (RTX) treatment.
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