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Case Reports
. 2021 Oct 27;21(1):414.
doi: 10.1186/s12883-021-02449-5.

MOG antibody-associated encephalitis secondary to Covid-19: case report

Ervin Durovic  1 , Corinna Bien  2 , Christian G Bien  3 , Stefan Isenmann  4
Affiliations
Case Reports

MOG antibody-associated encephalitis secondary to Covid-19: case report

Ervin Durovic et al. BMC Neurol. .

Abstract

Background: While Covid-19 predominantly affects the respiratory system, neurological manifestations including encephalitis occur in some patients, possibly affecting the course and outcome of the disease. Here, we describe a unique case of a young man with Covid-19 and transient MOG-positive encephalitis, with a benign course.

Case presentation: A 22-year-old male, with PCR confirmed Covid-19 infection was admitted because of persistent headache. The clinical examination was normal. Neuropsychological testing revealed distinct executive deficits. Brain MRI and cerebrospinal fluid (CSF) analysis were suggestive for encephalitis. Further laboratory examination revealed a serum MOG antibody titre. The headache improved with analgetic treatment and i.v. methylprednisolone. Consequently, the MOG antibody titer decreased and MRI lesions were resolving. The patient made a full recovery, with no signs of deterioration over the following months.

Conclusions: Covid-19 manifestations in the CNS include encephalitis with variable course and prognosis. This case highlights a possible association between inflammation due to COVID-19 and transient secondary autoimmunity with transient MOG antibodies and atypical clinical presentation.

Keywords: COVID-19; Encephalitis; MOG antibody; Methylprednisolone; Neuropsychology; SARS-CoV-2.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Serial MRI examinations. A-D, at initial examination (d 11 after PCR diagnosis), FLAIR (A) showed increased signal intensity bilaterally, in the cortex and basal ganglia. B DWI showed only a small area of restricted diffusion in the right insular cortex. C There was no signal enhancement after i.v. gadolinium. D-F T2 images showing signal hyperintensities before (d 11) (D) and improvement after 5 days of i.v. methylprednisolone (d17; E). F Full resolution (d 35)
Fig. 2
Fig. 2
Live cell assay for the determination of antibodies against MOG. MOG-transfected human embryonic kidney cells (HEK, marked by the co-transfected intracellular green fluorescent protein [6] are bound by the MOG antibodies visualized by a red fluorochrome. Nuclear counterstaining in blue. Bar: 20 μm
See this image and copyright information in PMC

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