Early immunotherapy in a patient with myelin oligodendrocyte glycoprotein antibody-associated disease with syphilis and acquired immunodeficiency syndrome: a case report

Abstract

This is the case of a 41-year-old man who presented with blurred vision, unconsciousness, and fever with a positive Babinski sign on both sides. Blurred vision, unconsciousness, and fever are commonly seen in neurology and emergency settings, with a wide range of potential etiologies. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) often occurs after infection, but cases of syphilis and human immunodeficiency virus as precursors are rarely reported. We report a case of MOGAD with syphilis and acquired immunodeficiency syndrome. Additionally, the study summarizes the disease's clinical manifestations, therapy, prognosis, and outcome and highlights the importance of timely and accurate immune regulation therapy.

Keywords: HIV; MOGAD; central nervous system; inflammatory; syphilis.

Figure 1

(A) Four hours after the onset of symptoms, the computed tomography and magnetic resonance imaging (MRI) of the brain did not reveal obvious bleeding, infarction, etc. (B) One day after onset, the magnetic resonance angiography of the brain was normal. (C) Five days after symptom onset, the brain MRI demonstrated multiple abnormal signals on the T2 and T2 FLAIR sequences, mainly affecting the white matter as indicated by the arrow. Abnormal signals can be observed in C2–C4 and T5–T7 in the spinal cord. (D) The timeline, clinical symptoms, and therapy of the patient.