Frontiers in Pediatrics (Sep 2024)

MOG-antibody-associated transverse myelitis with the H-sign and unusual MRI enhancement: a case report and literature review

  • Lu Zhang,
  • Chuan Feng,
  • Ling He,
  • Shi-Yu Huang,
  • Xin-Yin Liu,
  • Xiao Fan

DOI
https://doi.org/10.3389/fped.2024.1451688
Journal volume & issue
Vol. 12

Abstract

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Transverse myelitis is the second most common symptoms in myelin oligodendrocyte antibody-associated diseases (MOGAD), causing obvious clinical manifestation. T2-hyperintense lesions mainly restricted to the gray matter in the spinal cord on axial magnetic resonance imaging, produce the H-sign, which is thought to be the typical finding of MOGAD. Contrast enhancement can be observed in some cases of myelin oligodendrocyte antibody-associated transverse myelitis (MOG-TM). However, reports on the enhancement pattern associated with the H-sign are rarely seen. In this report, we describe a case of pediatric MOG-TM in which the H-sign was observed without enhancement, while the surrounding white matter exhibited enhancement. This pattern contradicts the previously observed gray matter involvement. Then we reviewed the literatures of myelin oligodendrocyte antibody-positive myelitis to focus on the neuroimaging features and discuss the implications of our finding.

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