MOG IgG positive, and NMO IgG negative. Sudden problem in vision of one eye. Age 9 years, female. Treatment IVMP for five days. Please suggest the best possible treatment and please explain about the condition.
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MOG-antibodies are common in children with acute demyelinating syndromes (like optic neuritis in your case) with both monophasic and relapsing disease courses. MOG is myelin oligodendrocytes glycoprotein normally present on oligodendrocytes of brain, spinal cord and optic nerve myelinated neurons.
Many time during viral infection or due to some unknown reason, bodies immune cells falsely perceive it as a foreign particles and attack on it and it will damage the myelin sheeth. Mostly affects vision of eyes, spinal cord function and brain. Diagnosis is made by history and examinations, MRI brain and spine, CSF, NMO, MOG antibodies.
Treatment of patients with MOG-Ab-associated demyelination includes management of acute relapses and chronic immunotherapy for those with relapsing disease. Acute phase treatment: Best possible treatment in your case is IV Steroid for five days, already given. But in case severe disease, IV immunoglobulin or plasma exchange for five days, both will reinstall immunity but not indicated in your case as she is improving with steroids.
Maintenance with tablet Prednisolone 1 mg/kg/day for four to six weeks, then will slowly taper down and stop. But in case of relapse (further attacks) will have to continue for long time.
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