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Acute retrobulbar optic neuritis with anti-myelin oligodendrocyte glycoprotein antibody-associated disease complicated with microscopic polyangiitis: A case report
Authors:Tomoyuki Asano  Yuzuka Saito  Naoki Matsuoka  Jumpei Temmoku  Yuya Fujita  Kasumi Hattori  Shunsuke Kobayashi  Akira Ojima  Toshiyuki Takahashi  Haruki Matsumoto  Makiko Yashiro-Furuya  Shuzo Sato  Hiroko Kobayashi  Hiroshi Watanabe  Kiori Yano  Tomomi Sasajima  Kazuo Fujihara  Kiyoshi Migita
Abstract:
Rationale:Anti-myelin oligodendrocyte protein antibody-associated disease (MOGAD) is a new disease entity with various clinical phenotypes. MOGAD often present with recurrent optic neuritis (ON), and it can also develop as a compartment of neuromyelitis optica spectrum disorder (NMOSD). Moreover, multiple autoantibodies such as an anti-myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) had been reported in the serum of patients with NMOSD.Patient concerns:We report an 86-year-old woman with a 2-year history of microscopic polyangiitis (MPA). The patient had a rapid loss of vision in her left eye. No abnormal findings were observed on her left fundus, and she tested negative for MPO-ANCA upon admission. However, anti-MOG antibodies were observed in the patient''s serum and cerebrospinal fluid.Diagnosis:A diagnosis of MOGAD complicated with MPA was made.Interventions:The patient received twice steroid pulse therapy and oral azathioprine as maintenance therapy.Outcomes:Her vision rapidly recovered, and no subsequent relapse was observed during the 8-month observation period.Conclusion:To the best of our knowledge, this is the first case of MOGAD complicated with MPA, and steroid pulse therapy and azathioprine therapy were effective for ON caused by MOGAD.
Keywords:anti-MOG antibodies   microscopic polyangiitis   anti-myeloperoxidase antineutrophil cytoplasmic antibody   retrobulbar optic neuritis
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