{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:29:49Z","timestamp":1785583789411,"version":"3.56.0"},"reference-count":16,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,24]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Neuromyelitis optica spectrum disorder (NMOSD) is associated with anti-aquaporin-4 antibodies (AQP4-Ab), whereas myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is associated with anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Ab). Cases in which both antibodies coexist are rare. We describe a clinical case diagnosed with AQP4-Ab-positive NMOSD 7 years prior, who exhibited new symptoms that were similar to those of MOGAD during her third attack. She was ultimately diagnosed as being double positive for AQP4-Ab and MOG-Ab. Although a full treatment of steroid pulse and plasma exchange was administered, the patient had severe vision loss. Double-antibody-positive cases are very rare in NMOSD patients; however, the investigation of multiple possibilities remains important. When patients experience new symptoms or treatment responses during attacks, a new antibody association should always be considered.<\/jats:p>","DOI":"10.1136\/bcr-2025-266170","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T04:30:30Z","timestamp":1749702630000},"page":"e266170","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Relapsing anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder diagnosed double positive for anti-myelin oligodendrocyte glycoprotein antibody"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4967-9716","authenticated-orcid":false,"given":"Sachi","family":"Nishino","sequence":"first","affiliation":[{"name":"Ophthalmology, Shiga University of Medical Science Hospital, Otsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Tamura","sequence":"additional","affiliation":[{"name":"Neurology, Shiga University of Medical Science Hospital, Otsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Ophthalmology, Shiga University of Medical Science Hospital, Otsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Ohji","sequence":"additional","affiliation":[{"name":"Ophthalmology, Tane Memorial Eye Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"2025082701510943000_18.6.e266170.1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001729"},{"key":"2025082701510943000_18.6.e266170.2","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(22)00431-8"},{"key":"2025082701510943000_18.6.e266170.3","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.ophtha.2019.04.042","article-title":"Epidemiologic and Clinical Characteristics of Optic Neuritis in Japan","volume":"126","author":"Ishikawa","year":"2019","journal-title":"Ophthalmology"},{"key":"2025082701510943000_18.6.e266170.4","unstructured":"Multiple Sclerosis International Federation . 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