Clinical significance of assaying anti-MOG antibody in cerebrospinal fluid in MOG-antibody-associated diseases: A case report

The serum diagnosis of anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab) associated diseases can be confirmed by the presence of the MOG-Ab, yet its levels in cerebrospinal fluid (CSF) are of unknown significance. We report the case of a 59-year-old woman with a history of 12 recurrent central nervous system lesions in the optic nerve, cerebrum, and spinal cord. The woman's condition improved by each steroid therapy. She tested seronegative for MOG-Ab, yet CSF-positive, leading to a diagnosis of MOG-Ab-associated encephalomyelitis. Our experience suggests measuring MOG-Ab in CSF and serum to prevent the underdiagnosis of MOG-Ab-associated diseases.