title: Severe demyelination but no astrocytopathy in clinically definite neuromyelitis optica with anti-myelin-oligodendrocyte glycoprotein antibody.
abstract: We report a patient with neuromyelitis optica (NMO) presenting anti-myelin-oligodendrocyte glycoprotein (MOG)-seropositive, in whom biomarkers of demyelination and astrocyte damage were measured during an acute attack. A 31-year-old man developed right optic neuritis followed by longitudinally extensive transverse myelitis, fulfilling the criteria for definite NMO. He was anti-MOG-seropositive and anti-aquaporin-4 seronegative. The myelin basic protein level was markedly elevated whereas glial fibrillary acidic protein was not detectable in cerebrospinal fluid during an acute attack. His symptoms quickly improved after high-dose methylprednisolone therapy. This case suggests that NMO patients with anti-MOG may have severe demyelination in the absence of astrocyte injury.
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kiyota
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan dakuro@med.tohoku.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Douglas Kazutoshi
authors.initials: DK
authors.lastname: Sato
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiyama
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Misu
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakashima
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan/Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fujihara
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Aoki
mesh_terms: D000328:Adult; D019138:Antibodies, Blocking / Q000627:therapeutic use*; D001253:Astrocytes / Q000473:pathology*; D003711:Demyelinating Diseases / Q000473:pathology*; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000037:antagonists & inhibitors* / Q000276:immunology*; D009188:Myelitis, Transverse / Q000150:complications; D009471:Neuromyelitis Optica / Q000473:pathology* / Q000628:therapy*; D018696:Neuroprotective Agents / Q000627:therapeutic use
chemical_list: D019138:Antibodies, Blocking; D005904:Glial Fibrillary Acidic Protein; D063308:Myelin-Oligodendrocyte Glycoprotein; D018696:Neuroprotective Agents; D008775:Methylprednisolone
keywords: Neuromyelitis optica; aquaporin-4; glial fibrillary acidic protein; myelin basic protein; myelin-oligodendrocyte glycoprotein