Patient with Myelin Oligodendrocyte Glycoprotein Associated Disease and Thrombophilia: Case Report

Activity: Talk or presentation types › Poster presentation

Description

MOG (Myelin Oligodendrocyte Glycoprotein) antibodies have been identified as a potential cause of neurological disorders, including optic neuritis, which is an inflammatory disorder that affects optic nerves, while thrombophilia is a condition that increases the risk of blood clots. The aim of this study is to present the complexity of treating patients with concomitant rare diseases.. .. A 59-year-old female experienced four episodes of anti-MOG antibodies-associated optic neuritis. The first episode in January 2022 resulted in complete blindness in the right eye. The patient received Methylprednisolone 3000mg intravenously continuing with oral Methylprednisolone 48mg by decreasing doses, which led to gradual recovery of vision. Reducing steroid doses, the patient developed worsening vision in the left eye in March and April 2022, therefore receiving the same therapy as previous. In May 2022, an MRI revealed bilateral retrobulbar lesions within the optic nerves without other abnormalities. Further investigation detected positive MOG antibodies in cerebrospinal fluid. Therefore, the therapy with Mycophenolate mofetil 1000mg twice a day was started, continuing to receive oral Methylprednisolone 48mg by gradually reducing doses. The patient experienced another recurrent neuritis in September 2022 despite the therapy. Upon further investigation subsequent MRI with a one-month interval showed asymptomatic strokes in the right middle cerebral artery. Other potential stroke causes were excluded, so genetic analysis was performed, identifying Leiden V heterozygous and homozygous mutations, confirming diagnosis of thrombophilia, for which the patient initiated oral anticoagulant therapy. Considering underlying disease course, in December 2022, the patient was prescribed Rituximab 1000mg intravenously twice with a two-week interval, continuing to receive Mycophenolate mofetil and Methylprednisolone 16mg. There have been no recurrent episodes since receiving therapy.. The case highlights complexity of treating patients with concomitant rare diseases, emphasizing the need for a comprehensive approach to diagnosis and treatment, including alternative therapies in addition to first-line treatment.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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