Pediatric myelin oligodendrocyte glycoprotein antibody associated disease following incomplete Kawasaki – a case report with varied association

Abstract

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has emerged as a distinct inflammatory demyelinating disorder of the central nervous system. Although relatively rare, growing recognition of this entity has highlighted important differences from multiple sclerosis and neuromyelitis optica spectrum disorder, particularly with respect to clinical phenotype, neuroimaging features, and long-term prognosis. We report a 5-year-old girl who presented with acute, painful, and progressive diminution of vision in the right eye, accompanied by impaired color perception for 3 days. Cerebrospinal fluid analysis was unremarkable, with antibody testing negative for neuromyelitis optica spectrum disorder (NMOSD) and positive for myelin oligodendrocyte glycoprotein (MOG) antibodies. She had a recent history of incomplete Kawasaki disease treated with intravenous immunoglobulin one month prior. While systemic corticosteroids led to partial visual improvement, complete recovery was achieved following intravenous immunoglobulin therapy. This case highlights the importance of assessing MOG-IgG antibodies in pediatric patients presenting with optic neuritis. Precise differentiation from other demyelinating disorders is essential for accurate diagnosis and appropriate management. The overall prognosis is generally favorable.