{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:16:51Z","timestamp":1773649011338,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,6,9]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Myelin oligodendrocyte glycoprotein-antibody disease (MOGAD) is an immune-mediated demyelinating disorder, distinct from MS, which typically affects the optic nerve, spinal cord, brain and\/or brainstem. Diffuse white matter involvement that resembles a leukodystrophy has been reported only in children. We present a woman aged 29 years with new right optic neuritis on a background of previously unexplained, longstanding, bilateral, reduced visual acuity. MR scan of the brain and orbits showed confluent, bilateral, posterior predominant white matter changes reminiscent of a leukodystrophy, along with bilateral optic atrophy. She was strongly MOG-seropositive. Positron-emission tomography scanning showed enlarged cervical lymph nodes, and biopsy found necrotising granulomata without tuberculosis. She showed a marked clinico-radiological response to corticosteroids, going from legally blind to functioning independently. Most strikingly, the chronically affected left eye improved significantly, 5 years after symptom onset. This expands the phenotypic spectrum of MOGAD as well as therapeutic expectations after a delayed presentation.<\/jats:p>","DOI":"10.1136\/pn-2025-004662","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T13:20:21Z","timestamp":1750684821000},"page":"183-187","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Myelin oligodendrocyte glycoprotein-antibody disease (MOGAD) with leukodystrophy-like presentation"],"prefix":"10.1136","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4455-5898","authenticated-orcid":false,"given":"Viveka","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5577-9427","authenticated-orcid":false,"given":"Emma A","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onn Min","family":"Kon","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Millard","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maddalena","family":"Cerrone","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Nicholas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Scalfari","sequence":"additional","affiliation":[{"name":"Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A","family":"Varley","sequence":"additional","affiliation":[{"name":"Department of Neurology, Imperial College Healthcare NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"2026031600451070000_26.2.183.1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(22)00431-8"},{"key":"2026031600451070000_26.2.183.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8781-3"},{"key":"2026031600451070000_26.2.183.3","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.13649"},{"key":"2026031600451070000_26.2.183.4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4103\/aian.aian_983_23","article-title":"Adrenoleukodystrophy-Like Presentation of MOG-Antibody-Associated Demyelination","volume":"27","author":"Viswanathan","year":"2024","journal-title":"Ann Indian Acad Neurol"},{"key":"2026031600451070000_26.2.183.5","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1177\/13524585221090737","article-title":"Progressive myelin oligodendrocyte glycoprotein-associated demyelination mimicking leukodystrophy","volume":"28","author":"Gibbons","year":"2022","journal-title":"Mult Scler"},{"key":"2026031600451070000_26.2.183.6","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000200293","article-title":"Different Complement Activation Patterns Following C5 Cleavage in MOGAD and AQP4-IgG+NMOSD","volume":"11","author":"Kaneko","year":"2024","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"2026031600451070000_26.2.183.7","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000200065","article-title":"Early Immunotherapy and Longer Corticosteroid Treatment Are Associated With Lower Risk of Relapsing Disease Course in Pediatric MOGAD","volume":"10","author":"Nosadini","year":"2023","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"2026031600451070000_26.2.183.8","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2024-333463"},{"key":"2026031600451070000_26.2.183.9","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1001\/jamaneurol.2020.3115","article-title":"Long-term Outcomes in Patients With Myelin Oligodendrocyte Glycoprotein Immunoglobulin G-Associated Disorder","volume":"77","author":"Lopez-Chiriboga","year":"2020","journal-title":"JAMA Neurol"},{"key":"2026031600451070000_26.2.183.10","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1002\/ana.26731","article-title":"Do Early Relapses Predict the Risk of Long-Term Relapsing Disease in an Adult and Paediatric Cohort with MOGAD?","volume":"94","author":"Chen","year":"2023","journal-title":"Ann Neurol"},{"key":"2026031600451070000_26.2.183.11","doi-asserted-by":"crossref","first-page":"100123","DOI":"10.1016\/j.nerep.2022.100123","article-title":"Drug resistant tuberculosis, Myelitis and MOG antibody","volume":"2","author":"Miraclin T","year":"2022","journal-title":"Neuroimmunology Reports"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2025-004662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T07:46:04Z","timestamp":1773647164000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2025-004662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,23]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/pn-2025-004662"],"URL":"https:\/\/doi.org\/10.1136\/pn-2025-004662","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,23]]}}}