Italian 
English Neuromielite ottica in età pediatrica: il laboratorio può essere utile?
Case report: laboratory follow up of myelin oligodendrocyte glycoprotein antibodies titre associated to neuromyelitis optica spectrum disorder
AUTORI
1UOC Medicina di Laboratorio, Didas Servizi di Diagnostica Integrata, Azienda Ospedale – Università di Padova
2Neurologia e Neurofisiologia Pediatrica, Didas Salute della Donna e del Bambino, Azienda Ospedale – Università di Padova
3Gruppo di Neuroimmunologia, Istituto di Ricerca Pediatrica-Fondazione "Città della Speranza", Padova
4Dipartimento di Medicina - DIMED, Università di Padova
Questo lavoro è stato in parte presentato al 52° Congresso Nazionale SIBioC, 6-8 Ottobre 2020, Virtual Edition, nella Sessione Casi Cinici
ABSTRACT
Case report: laboratory follow up of myelin oligodendrocyte glycoprotein antibodies titre associated to neuromyelitis optica spectrum disorder
In September 2018 a previously healthy 6-years-old female was admitted for unspecific visual impairment. Physical examination revealed bilateral papilledema with haemorrhage signs, torpid photomotor reflex and slow eye-blink reflex. No other physical abnormalities or alterations in routine laboratory workup were found.
Brain imaging showed alterations in cortical white matter; both optic nerves and cervical spinal cordanti aquaporin-4 antibodies (AQP4-Ab) and myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) testing was then ordered suspecting a neuromyelitis optica spectrum disorder (NMOSD).
MOG-Ab positivity was found at >1:160 and at 1:40 titre in serum and in cerebrospinal fluid respectively. After steroid treatment, the titre in serum was still positive at 1:160, with mild clinical recovery. Clinical and laboratory follow up was maintained for 1 year, highlighting a fluctuating antibody titre related to both the clinical course and the immunosuppressive treatment.
The need of MOG-Ab laboratory follow-up is still debated, nevertheless it might be useful in predicting clinical relapse, as the presentation of this case report illustrates.