A Case of Myelin Oligodendrocyte Glycoprotein Antibody Disease in a Pediatric Patient: Clinical Presentation, Treatment Response, and Follow-Up Considerations

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a rare autoimmune demyelinating disorder that targets the central nervous system and is characterized by antibodies that act against myelin oligodendrocyte glycoprotein (MOG). This disorder typically manifests with symptoms such as optic neuritis, transverse myelitis, or encephalitis, leading to symptoms such as vision loss, muscle weakness, sensory disturbances, and cognitive impairment. We present the case of a 10-year-old male who was eventually diagnosed with MOGAD after consideration of several other neurological and musculoskeletal disorders, who was admitted to the hospital due to an initial presentation of urinary retention and pelvic pain. The patient's clinical course included an MRI scan showing extensive demyelinating lesions in the spinal cord, along with positive MOG antibody serology. Management involved a multidisciplinary approach, including consultations from neurology, physical therapy, and the general pediatrics team, as well as administration of high-dose corticosteroids. This case underscores the importance of early recognition and aggressive treatment of MOGAD, a disorder that can present similarly to other demyelinating diseases such as multiple sclerosis and neuromyelitis optica spectrum disorder, with the distinguishing feature of MOGAD being the presence of antibodies against MOG.