Severe demyelination but no astrocytopathy in clinically definite neuromyelitis optica with anti-myelin-oligodendrocyte glycoprotein antibody

Mult Scler. 2015 Apr;21(5):656-9. doi: 10.1177/1352458514551455. Epub 2014 Sep 25.


We report a patient with neuromyelitis optica (NMO) presenting anti-myelin-oligodendrocyte glycoprotein (MOG)-seropositive, in whom biomarkers of demyelination and astrocyte damage were measured during an acute attack. A 31-year-old man developed right optic neuritis followed by longitudinally extensive transverse myelitis, fulfilling the criteria for definite NMO. He was anti-MOG-seropositive and anti-aquaporin-4 seronegative. The myelin basic protein level was markedly elevated whereas glial fibrillary acidic protein was not detectable in cerebrospinal fluid during an acute attack. His symptoms quickly improved after high-dose methylprednisolone therapy. This case suggests that NMO patients with anti-MOG may have severe demyelination in the absence of astrocyte injury.

Keywords: Neuromyelitis optica; aquaporin-4; glial fibrillary acidic protein; myelin basic protein; myelin-oligodendrocyte glycoprotein.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Blocking / therapeutic use*
  • Astrocytes / pathology*
  • Demyelinating Diseases / pathology*
  • Glial Fibrillary Acidic Protein / metabolism
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Methylprednisolone / therapeutic use
  • Myelin-Oligodendrocyte Glycoprotein / antagonists & inhibitors*
  • Myelin-Oligodendrocyte Glycoprotein / immunology*
  • Myelitis, Transverse / complications
  • Neuromyelitis Optica / pathology*
  • Neuromyelitis Optica / therapy*
  • Neuroprotective Agents / therapeutic use


  • Antibodies, Blocking
  • Glial Fibrillary Acidic Protein
  • Myelin-Oligodendrocyte Glycoprotein
  • Neuroprotective Agents
  • Methylprednisolone