We aim to review Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) cases at our institution, to complement existing published data for future changes to disease guidelines.

Most published literature on MOGAD focuses on typical rather than atypical MOGAD presentations. Published MOGAD guidelines emphasize the need for further studies for validation.

This is a descriptive retrospective case series. Positive serum anti-Myelin Oligodendrocytes Glycoprotein (MOG) antibody titers between March 2018 to June of 2023 were identified through EHR reporting tools and charts were accessed for review on or before September 18, 2023. IRB approval was obtained. 

Seventy-two patients had positive anti-MOG antibody titers and fifty-five patients met criteria for MOGAD. Of those, 65.5% were female and 32.7% were children. Most commonly, MOGAD presented as optic neuritis in 74.5%, acute disseminated encephalomyelitis (ADEM) in 23.6%, and transverse myelitis in 14.5% of cases. Atypical syndromes included myeloradiculitis, seizures, concomitant NMDA positivity, crossover tumefactive demyelinating syndrome, isolated brainstem involvement, adult ADEM and transverse myelitis in pregnancy. Disease recurred in 43.6% patients overall (44.4% of pediatric and 43.2% of adult patients). Serum anti-MOG antibody titers ranged between 1:20-1:10000. Upon presentation, most patients received intravenous steroids, with some receiving additional IVIG or PLEX. 63.6% of patients (50% of pediatric and 70.2% of adult patients) received maintenance therapy, most commonly rituximab followed by mycophenolate mofetil in adults and IVIG in children.