Case studyHashimoto's encephalopathy and anti-MOG antibody encephalitis: 50 years after Lord Brain's description

- A girl with Hashimoto's encephalopathy (HE) had elevated anti-MOG Abs.
- We propose that a subset of patients with HE have anti-MOG Ab associated encephalitis.
- 26% of children reported with HE have clinical and radiologic features potentially consistent with anti-MOG Ab associated encephalitis.

PurposeTo consider the role of anti-MOG Abs associated encephalitis in Hashimoto's Encephalitis (HE).ResultsA 10 year old girl with pre-existing Hashimoto's thyroiditis presented with dysarthria, ataxia and lethargy whilst euthyroid. Brain MRI showed multifocal T2 and FLAIR hyperintense lesions. She responded promptly to treatment with corticosteroids. Her clinical scenario was comparable to a sizeable minority of patients diagnosed with HE in the literature, who have similar brain MRIs. Serum was positive for anti-myelin oligodendrocyte glycoprotein (MOG) Ab, implicating this antibody-mediated process in this patient's illness.ConclusionWe hypothesize that anti-MOG Ab associated demyelination may underlie a subset of patients with HE.