Objective:To explore the clinical features of first-episode adult anti-myelin oligodendrocyte glycoprotein-IgG associated disorders (MOGAD).

Methods:A retrospective analysis was performed for the general data, clinical manifestations and phenotype, serum MOG-IgG titers, imaging data, treatment and prognosis of 16 adult patients with first-episode MOGAD who were admitted to the Department of Neurology of Beijing Dawang Road Emergency Hospital and Beijing Chaoyang Integrative Medicine Emergency Hospital from June 2020 to June 2023.

Results:Among the 16 patients, 6 were males and 10 were females, with a median age of 37 years. The clinical manifestations were consistent with optic neuritis (ON) in 7 cases (7/16, 43.8%), meningoencephalitis in 7 cases(7/16, 43.8%), myelitis in 2 cases (2/16, 12.5%), and brainstem encephalitis in 1 case (1/16, 6.2%), of which 1 case (1/16, 6.2%) was ON combined with meningoencephalitis. Serum MOG-IgG titer was 1:10 to 1:100. Before treatment, all patients had lesions on MRI examination, 7 cases (7/16, 43.8%) involved the optic nerve, 6 cases(6/16, 37.5%) involved the cerebral cortex, 2 cases (2/16, 12.5%) involved the leptomeninges, 2 cases (2/16, 12.5%) involved the thoracic spinal cord, and 1 case(1/16, 6.2%) involved the pons. There were 15 cases (15/16, 93.8%) with enhancement and 1 case (1/16, 6.2% ) without enhancement, which showed patchy, punctate and linear enhancement. All included patients were treated with intravenous methylprednisolone pulse in the acute phase, and 13 (13/16, 81.2%) patients were treated with intravenous immunoglobulin. All patients in remission were maintained with low-dose prednisone, and 4 patients (4/16, 25%) were treated with mycophenolate mofetil. After 2 months of treatment, 9 patients recovered well (9/16, 56.2%), and 7 cases recovered poorly (7/16, 43.8%).

Conclusion:The clinical manifestations of MOGAD are complex, and for patients with ON, meningoencephalitis, brainstem encephalitis and myelitis, serum MOG-IgG antibodies should be further tested to rule out MOGAD, and relevant immunotherapy should be actively carried out after diagnosis.