A case of AQP4-MOG double-positive neuromyelitis optica spectrum disorder

Title : A case of AQP4-MOG double-positive neuromyelitis optica spectrum disorder

Abstract:

Neuromyelitis optica spectrum disorder (NMOSD) is an immune-mediated disorder of the central nervous system (CNS) characterized by frequent involvement of the optic nerves and spinal cord. Autoantibodies against aquaporin-4 channels on astrocytes (Anti-AQP4) are the hallmark of this disease. This is a distinct entity from myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) where patients may present with a wide spectrum of manifestations including an NMOSD phenotype, however, being defined by the presence of antibodies against the myelin oligodendrocyte protein (anti-MOG). The clinical and radiological overlap of these disorders has prevented them from being recognized as independent entities until 2023, when separate diagnostic criteria were published. We would like to present a case of a 53 year-old-woman with dual anti-AQP4 and anti-MOG seropositivity and explore the significance of this finding amongst the new NMOSD and MOGAD diagnostic criteria and the underlying pathophysiology of the two disorders.

Biography:

Dr Butler is a Basic Physician Trainee at The Alfred Hospital in Melbourne, Australia. She completed her MD and BmedSc (Hons) at Monash University in 2021. Alongside her Physician’s training, Dr Butler has a keen interest in sports concussion. She is currently completing research with the Monash Trauma Group which focuses on applied research in traumatic brain injury and works as a concussion spotter at the Australian Football league.