Case Reports in Neurological Medicine (Jan 2018)

Leptomeningeal and Intraparenchymal Blood Barrier Disruption in a MOG-IgG Positive Patient

  • Sayed Hamid Mohseni,
  • Hanne Pernille Bro Skejoe,
  • Jens Wuerfel,
  • Friedemann Paul,
  • Markus Reindl,
  • Nasrin Asgari

DOI
https://doi.org/10.1155/2018/1365175
Journal volume & issue
Vol. 2018

Abstract

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Background. A serum immunoglobulin G (IgG) autoantibody specific for the myelin oligodendrocyte glycoprotein (MOG) is detected in the subgroup patients with inflammatory demyelinating diseases of the central nervous system (CNS). However, whether MOG-IgG contributes to blood-brain barrier (BBB) impairment remains poorly characterized. Findings. We report a 30-year-old previously healthy female who presented with attacks on the optic nerves and a demyelinating spinal cord lesion, in which the blood–CNS barriers including leptomeningeal blood barrier and BBB were altered, as demonstrated by gadolinium-enhanced MRI during relapse. Blood samples taken at onset and four years later were retrospectively found positive for MOG-IgG. Conclusion. Our findings demonstrate that MRI-detected leptomeningeal enhancement occurs in MOG-IgG positive patients, accompanying intraparenchymal BBB breakdown during attack. The findings suggest that meningeal inflammation occurs following MOG-IgG-related parenchymal inflammation.