PMC7724101_01
Clinical and serological time course. Arrow heads denote relapses. MMF, mycophenolate mofetil; PE, plasma exchange; IVMP, intravenous methylprednisolone; MOG-Ab, myelin oligodendrocyte glycoprotein antibodies.
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F1
She tested positive for serum MOG-IgG1 antibodies by live cell-based assay after her second relapse, confirming a diagnosis of MOGAD and remained persistently positive for more than 3.5 years before MOG IgG1 became negative and MOG-antibody titers fell below the cut-off of 1:200 (Figure 1). Due to side-effects, corticosteroids were tapered to cessation over 12 weeks, but she remained on MMF (Figure 1). However, MOG-IgG1 was strongly positive indicating "seroreversion" with an increase in MOG antibody end-point titer to 1:800 (Figure 1). MOG-antibody titers reduced to 1:200 (Figure 1). MMF was increased to 3 g/day and she was recommenced on prednisolone (40 mg/day) with a plan to slowly taper to a maintenance dose of 10 mg/day.