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

• Main Authors: Sayed Hamid Mohseni, Hanne Pernille Bro Skejoe, Jens Wuerfel, Friedemann Paul, Markus Reindl, Nasrin Asgari
• Format: Article
• Language: English
• Published: Hindawi Limited 2018-01-01
• Series: Case Reports in Neurological Medicine
• Online Access: http://dx.doi.org/10.1155/2018/1365175

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.