Coexisting myelin oligodendrocyte glycoprotein antibody-associated disease and spinal dural arteriovenous fistula: A diagnostic and neuroimmunological challenge.
Changman Deng, Yiran Zhang, Jie Shen et al.
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Case in brief
A 78-year-old woman presented with worsening bilateral lower limb numbness, weakness, and fecal incontinence over two months. MRI revealed a longitudinally extensive spinal cord lesion, and serological tests confirmed MOG antibodies at a titer of 1:100. After glucocorticoid treatment, she showed partial improvement, but further imaging revealed a spinal arteriovenous malformation, highlighting diagnostic complexities.
Diagnostic / clinical pearl
This case illustrates that the presence of MOG antibodies and partial response to glucocorticoids do not exclude the possibility of concurrent vascular pathologies in patients with myelopathy.
Why it matters
The findings emphasize the need for thorough diagnostic evaluations, including vascular imaging, in cases of atypical or progressive myelopathy to avoid misdiagnosis.