Longitudinally extensive transverse myelitis with anti-myelin oligodendrocyte glycoprotein antibodies following SARS-CoV-2 infection

Costa, Mariana Dias da; Rato, Miguel Leal; Cruz, Diana Pinho; Valadas, Anabela; Antunes, Ana; Albuquerque, Luı́sa

doi:10.1016/j.jneuroim.2021.577739

Cited by 20 publications

(20 citation statements)

References 16 publications

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“…2. Cases of MOGAD have recently been reported following both SARS-CoV-2 infection and vaccination (150,151). Although prodromal episodes of infection or vaccination are known to occur in up to one third of MOGAD patients (53), the overall risk of developing MOGAD or a MOGAD relapse after SARS-CoV-2 infection/vaccination appears to be extremely low (152), given the extremely high prevalence of the infection and vaccination without an associated observed large increase in MOGAD cases (153).…”

Section: Special Settings Potentially At Higher Risk Of Neurological ...mentioning

confidence: 99%

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): A Review of Clinical and MRI Features, Diagnosis, and Management

et al. 2022

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Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is the most recently defined inflammatory demyelinating disease of the central nervous system (CNS). Over the last decade, several studies have helped delineate the characteristic clinical-MRI phenotypes of the disease, allowing distinction from aquaporin-4 (AQP4)-IgG-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD) and multiple sclerosis (MS). The clinical manifestations of MOGAD are heterogeneous, ranging from isolated optic neuritis or myelitis to multifocal CNS demyelination often in the form of acute disseminated encephalomyelitis (ADEM), or cortical encephalitis. A relapsing course is observed in approximately 50% of patients. Characteristic MRI features have been described that increase the diagnostic suspicion (e.g., perineural optic nerve enhancement, spinal cord H-sign, T2-lesion resolution over time) and help discriminate from MS and AQP4+NMOSD, despite some overlap. The detection of MOG-IgG in the serum (and sometimes CSF) confirms the diagnosis in patients with compatible clinical-MRI phenotypes, but false positive results are occasionally encountered, especially with indiscriminate testing of large unselected populations. The type of cell-based assay used to evaluate for MOG-IgG (fixed vs. live) and antibody end-titer (low vs. high) can influence the likelihood of MOGAD diagnosis. International consensus diagnostic criteria for MOGAD are currently being compiled and will assist in clinical diagnosis and be useful for enrolment in clinical trials. Although randomized controlled trials are lacking, MOGAD acute attacks appear to be very responsive to high dose steroids and plasma exchange may be considered in refractory cases. Attack-prevention treatments also lack class-I data and empiric maintenance treatment is generally reserved for relapsing cases or patients with severe residual disability after the presenting attack. A variety of empiric steroid-sparing immunosuppressants can be considered and may be efficacious based on retrospective or prospective observational studies but prospective randomized placebo-controlled trials are needed to better guide treatment. In summary, this article will review our rapidly evolving understanding of MOGAD diagnosis and management.

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Section: Special Settings Potentially At Higher Risk Of Neurological ...mentioning

confidence: 99%

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): A Review of Clinical and MRI Features, Diagnosis, and Management

et al. 2022

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“…MOG-associated disorder (MOG-AD) is a distinct demyelinating disorder with a phenotype and an outcome different from that of multiple sclerosis and neuromyelitis optica spectrum disorder (NMOSD). Twelve cases of MOGAD have been associated with COVID-19 in the literature, mostly in adult males (8/12) with optic neuritis or encephalomyelitis [ [7] , [8] , [9] , [10] , [11] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ]. Our case series confirms that the onset of MOGAD can be triggered by SARS-CoV-2 infection and that 16% (3/19) of children with a neuro-inflammatory disease triggered by SARS-CoV-2 had MOG antibodies.…”

Section: Discussionmentioning

confidence: 99%

“…Severe inflammatory central nervous system (CNS) events, such as encephalitis, acute disseminated encephalomyelitis (ADEM), optic neuritis are rare, but have also been reported in case reports or small series of cases[ 5 , 6 ]. there are case reports of positive MOG (myelin-oligodendrocyte) antibodies (9 adults and 3 children with encephalomyelitis or optic neuritis)[ [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ].…”

Section: Introductionmentioning

confidence: 99%

Neuroinflammatory Disease following Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children

Aubart

Roux

Durrleman

et al. 2022

The Journal of Pediatrics

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“…SARS-CoV-2 is also associated with increased angiotensin-converting enzyme (ACE) in the CSF [ 48 ], which could be related to the hypothesized entry pathway for SARS-CoV-2 [ 49 ]. Furthermore, SARS-CoV-2 CNS infection shows an increase in the CSF high-sensitivity C-reactive protein (hsCRP) and oligoclonal band levels [ 50 ]. However, analysis of the CSF in COVID-19 negative patients has identified the presence of antibody markers against COVID-19 [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of COVID-19 Presence in CSF: Systematic Review of Case Reports

Elmakaty

Ferih

Karen

et al. 2022

Cells

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This systematic review focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients that had detected SARS-CoV-2 virus in cerebrospinal fluid (CSF). A systematic literature search was carried out in PubMed, Embase, Scopus, Web of Science, Medrxiv, and Biorxiv databases from inception to 19 December 2021. Case reports or case series involving patients with proved SARS-CoV-2 presence in CSF by polymerize chain reaction were included. Our search strategy produced 23 articles documenting a total of 23 patients with positive SARS-CoV-2 in the CSF. Fever (55%) was the most common symptom, followed by headaches (41%), cough (32%), and vomiting/nausea (32%). The majority of the cases included was encephalitis (57%), 8 of which were confirmed by magnetic resonance imaging. The second most prevalent presentation was meningitis. The cerebral spinal fluid analysis found disparities in protein levels and normal glucose levels in most cases. This study demonstrates that SARS-CoV-2 can enter the nervous system via various routes and cause CNS infection symptoms. SARS-CoV-2 has been shown to infect the CNS even when no respiratory symptoms are present and nasopharyngeal swabs are negative. As a result, SARS-CoV-2 should be considered as a possible cause of CNS infection and tested for in the CSF.

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Longitudinally extensive transverse myelitis with anti-myelin oligodendrocyte glycoprotein antibodies following SARS-CoV-2 infection

Cited by 20 publications

References 16 publications

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): A Review of Clinical and MRI Features, Diagnosis, and Management

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): A Review of Clinical and MRI Features, Diagnosis, and Management

Neuroinflammatory Disease following Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children

Clinical Implications of COVID-19 Presence in CSF: Systematic Review of Case Reports

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