FLENI
Neuroimmunology

Author Of 1 Presentation

Reproductive Aspects and Pregnancy Poster Presentation

P1128 - MOG antibody disease and pregnancy (ID 882)

Speakers
Presentation Number
P1128
Presentation Topic
Reproductive Aspects and Pregnancy

Abstract

Background

Anti-myelin oligodendrocyte glycoprotein (MOG) antibodies have been identified in several clinical phenotypes of demyelinating diseases, including acute disseminated encephalomyelitis, isolated optic neuritis (ON), and seronegative neuromyelitis optica. Manifestations during pregnancy and puerperium have not been described.

Objectives

To describe two cases of non relapsing anti-MOG ON presenting during pregnancy and early puerperium. Both cases negativized six months after delivery.

Methods

Case reports. Both patients signed informed consent. Samples were analyzed for binding to AQP4 and MOG using fixed cell-based assays (Euroimmun). Antibodies to full-length AQP4 and MOG were detected with anti-human IgG1.

Results

Case 1. 35-year-old female presented, 15 days after delivery, retro-orbital pain and severe vision loss of the left eye (LE). General examination was normal. In the LE, visual acuity (VA) was hand motion and fundus revealed a mild optic disc edema. Right eye (RE) exam was normal. Brain MRI was normal, orbit MRI showed enhancement of the left optic nerve and perineural enhancement with extension of the surrounding orbital tissues. CSF was normal and oligoclonal bands negative. AQP4-IgG was negative, and MOG-IgG was positive. She received 1000 mg of intravenous (IV) methylprednisolone for three day with complete recovery in a week. She did not experience any recurrence during 2 years of follow up. No further treatment was established. Anti-MOG-IgG was repeated and resulted negative 6 and 18 months after the event.

Case 2. 34 years-old women at week 30 of gestation presented headache and severe bilateral visual loss (20/100 LE, 20/70 RE). Fundus, general examination and brain MRI were normal. Orbit MRI showed slight hyperintensity of the left optic nerve. Gadolinium was not used because of pregnancy. AQP4-IgG was negative, and anti-MOG-IgG was positive. She received 500 mg of IV methylprednisolone for three days with complete recovery of vision in two months. She delivered a healthy baby at term. Anti-MOG-IgG was repeated at 6 months of puerperium and resulted negative. No further treatment was established.

Conclusions

We report two cases of non-relapsing anti-MOG-ON presenting in late pregnancy and early puerperium that spontaneously negativized during the follow up. Since anti-MOG-ON is associated with humoral immunity, pregnancy and delivery might adversely affect its course, as observed in other antibodies mediated autoimmune diseases.

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