Successful Maintenance Therapy with Intravenous Immunoglobulin to Reduce Relapse Attacks and Steroid Dose in a Patient with Refractory Myelin Oligodendrocyte Glycoprotein Antibody-positive Optic Neuritis

Intern Med. 2025 Mar 1;64(5):775-779. doi: 10.2169/internalmedicine.3593-24. Epub 2024 Aug 8.

Abstract

A 25-year-old Japanese man developed visual disturbance with eye pain and was diagnosed with optic neuritis associated with anti-myelin oligodendrocyte glycoprotein antibodies. His symptoms improved temporarily after steroid therapy but chronically relapsed many times after tapering the steroid dose. He became highly steroid-dependent and was referred to our department for reconsideration of the treatment strategy. Maintenance intravenous immunoglobulin (IVIg) therapy successfully decreased the annual recurrence rate from 1.15 to 0.27 times/year and the maintenance dose of oral prednisolone from 35 to 5 mg/day. Maintenance IVIg therapy is a promising option for preventing disease relapse in such cases.

Keywords: anti-MOG antibody-associated disease (MOGAD); chronically relapsing optic neuritis; maintenance intravenous immunoglobulin (IVIg) therapy; myelin oligodendrocyte glycoprotein (MOG).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoantibodies* / blood
  • Autoantibodies* / immunology
  • Humans
  • Immunoglobulins, Intravenous* / administration & dosage
  • Immunoglobulins, Intravenous* / therapeutic use
  • Male
  • Myelin-Oligodendrocyte Glycoprotein* / immunology
  • Optic Neuritis* / diagnosis
  • Optic Neuritis* / drug therapy
  • Optic Neuritis* / immunology
  • Prednisolone* / administration & dosage
  • Recurrence
  • Treatment Outcome

Substances

  • Immunoglobulins, Intravenous
  • Myelin-Oligodendrocyte Glycoprotein
  • Autoantibodies
  • Prednisolone