SHM Converge Scientific Abstract ePoster Gallery-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder: A Mimicker of Multiple Sclerosis

Pdf Summary

This case highlights Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder (MOGAD) as an important mimic of Multiple Sclerosis (MS). Although both are autoimmune demyelinating diseases of the central nervous system, they differ in pathophysiology, clinical patterns, MRI findings, and treatment response. MOGAD is often antibody-mediated, frequently causes severe optic neuritis and myelitis, and typically shows better recovery after attacks. MS more commonly follows a relapsing or progressive course and is managed with disease-modifying therapies.<br /><br />A 47-year-old woman developed progressive neurologic symptoms including gait impairment, numbness, weakness, vertigo, and a band-like thoracic sensation. Initial brain MRI was unremarkable, but later imaging revealed an enhancing brainstem and upper cervical cord lesion consistent with demyelination. She improved significantly with high-dose IV steroids and remained steroid-responsive and steroid-dependent. Workup showed positive serum MOG antibodies, negative AQP4 antibodies, and negative CSF oligoclonal bands, supporting the diagnosis of MOGAD. She was later transitioned off steroids and started on rituximab (Truxima).<br /><br />The discussion emphasizes that MOGAD can present with MS-like features, including short-segment myelitis and MRI lesions that resemble MS. Because treatment differs substantially, misdiagnosis can lead to ineffective or potentially harmful therapy. MOGAD patients may respond best to antibody-depleting treatments and may worsen with standard MS disease-modifying therapies. In addition, steroid tapering must be done cautiously because relapse risk is high after abrupt discontinuation.<br /><br />Overall, this case underscores the importance of considering MOGAD in patients with recurrent myelitis or steroid-responsive demyelinating disease and using serum MOG antibody testing to ensure accurate diagnosis and appropriate treatment.

Asset Subtitle

Sara Hassan

Meta Tag

Author List Frederick Acquah, Sara Hassan

Category Clinical Vignettes

Concept MOG Antibody-Associated Disease

Concept Multiple Sclerosis

Concept Optic Neuritis

Concept Myelitis

Concept Steroid Responsiveness

Distinguished Non-Finalist

Presenter Organization Ocean University Medical Center

Presenting Author Sara Hassan

Track Adult

Keywords

MOGAD

multiple sclerosis mimic

demyelinating disease

myelitis

optic neuritis

MRI lesions

serum MOG antibodies

AQP4 negative

steroid responsive

rituximab

MOG Antibody-Associated Disease

Multiple Sclerosis

Optic Neuritis

Myelitis

Steroid Responsiveness