MOGAD, Current Knowledge and Future Trends
Description:... Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOGAD) is a neurological, immune-mediated disorder targeting MOG protein, located on the outermost myelin sheaths in the central nervous system. The diagnosis is confirmed when serum MOG antibody is found in patients in the context of inflammatory attacks of the central nervous system, usually with the brain, brainstem, optic nerve, and spinal cord. Although MOGAD manifestations can fulfill diagnostic criteria for Neuromyelitis optica disorder (NMOSD), evidence suggests that they have distinct immunological mechanisms. Similar to NMOSD, patients with persistent MOG antibodies are at risk for recurrent events. Recovery of MOGAD is generally reasonable. However, some patients get disability after a severe acute attack. Treatment for an acute attack is typically intravenous high-dose steroids, plasma exchange (PLEX), or intravenous immunoglobulin (IVIG). Maintenance therapy with immunosuppressants, i.e., azathioprine, mycophenolate, rituximab, etc., usually prevents future attacks, although they have long-term side effects. Therefore, it is still controversial how long treatment should be continued.
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