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• Vol.56 No.4
• CLINICA NEUROL, 56: 265−269, 2016
• Vol.56 No.4 contents

Brief Clinical Note

A case of recurrent optic neuritis associated with cerebral and spinal cord lesions and autoantibodies against myelin oligodendrocyte glycoprotein relapsed after fingolimod therapy

Teiichiro Miyazaki, M.D.¹⁾, Hideki Nakajima, M.D., Ph.D.¹⁾, Masakatsu Motomura, M.D., Ph.D.¹⁾²⁾, Keiko Tanaka, M.D., Ph.D.³⁾, Yasuhiro Maeda, M.D.¹⁾⁴⁾, Hirokazu Shiraishi, M.D., Ph.D.¹⁾ and Akira Tsujino, M.D., Ph.D.¹⁾

¹⁾Department of Neurology and Strokology, Nagasaki University Hospital
²⁾Present Address: Medical Engineering Course, Department of Engineering, Faculty of Engineering, Nagasaki Institute of Applied Science
³⁾Department of Life Science, Medical Research Institute, Department of Neurology, Kanazawa Medical University
⁴⁾Present Address: Department of Neurology, National Hospital Organization, Nagasaki Kawatana Medical Center

A previously healthy 16-year-old girl developed sudden eye pain and visual loss in her right eye. On day 7 from onset her right visual acuity had decreased to light perception, and she underwent 5 courses of intravenous methylprednisolone therapy (IVMP, 1 g/day for 3 consecutive days per week). Her eye pain and her visual acuity had improved immediately. Eleven months later, follow-up MRI revealed three T₂-hyperintense plaques involving subcortical white matter in the left occipital lobe, right frontal lobe, right thalamus, and thoracic spinal cord. We suspected the diagnosis as multiple sclerosis and treated with fingolimod. She developed recurrent optic neuritis (ON) on day 19 from fingolimod therapy, and we stopped fingolimod. For two years from onset she was admitted five times due to recurrences of ON and appearance of white matter lesion and myelitis. At 22 months, anti-myelin oligodendrocyte glycoprotein (MOG) antibodies revealed to be positive in her sera from the onset to the present. Our case report suggests that fingolimod might not be effective in anti-MOG antibody-related disorders together with anti-aquaporin-4 (AQP4) antibody-positive group.
Full Text of this Article in Japanese PDF (679K)

(CLINICA NEUROL, 56: 265−269, 2016)
key words: anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, fingolimod, anti-MOG antibody-related disorders, optic neuritis

(Received: 22-Apr-15)