Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review

Michalina Rzepka; Mateusz Toś; Piotr Oleksy; Magdalena Reclik; Zuzanna Mularczyk; Aleksandra Śmigiel; Magdalena Błaszczyk; Joanna Siuda

doi:10.5114/ppn.2025.156790

eISSN: 2720-5371
ISSN: 1230-2813

Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii

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4/2025
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abstract:

Case report

Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review

Michalina Rzepka

^{1, 2}

,

Mateusz Toś

^{1, 2}

,

Piotr T. Oleksy

³

,

Magdalena Reclik

³

,

Zuzanna Mularczyk

³

,

Aleksandra Śmigiel

³

,

Magdalena Błaszczyk

²

,

Joanna Siuda

^{1, 2}

Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
University Clinical Centre of K. Gibiński, Katowice, Poland
Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland

Adv Psychiatry Neurol 2025; 34 (4): 294-306

DOI: https://doi.org/10.5114/ppn.2025.156790

Online publish date: 2025/12/08

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AMA

Rzepka M, Toś M, Oleksy PT, et al. Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii. 2025;34(4):294-306. doi:10.5114/ppn.2025.156790.

APA

Rzepka, M., Toś, M., Oleksy, P. T., Reclik, M., Mularczyk, Z.,  & Śmigiel, A. et al. (2025). Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, 34(4), 294-306. https://doi.org/10.5114/ppn.2025.156790

Chicago

Rzepka, Michalina, Mateusz Toś, Piotr T Oleksy, Magdalena Reclik, Zuzanna Mularczyk, Aleksandra Śmigiel,  and Magdalena Błaszczyk et al. 2025. "Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review". Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii 34 (4): 294-306. doi:10.5114/ppn.2025.156790.

Harvard

Rzepka, M., Toś, M., Oleksy, P., Reclik, M., Mularczyk, Z., Śmigiel, A., Błaszczyk, M.,  and Siuda, J. (2025). Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, 34(4), pp.294-306. https://doi.org/10.5114/ppn.2025.156790

MLA

Rzepka, Michalina et al. "Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review." Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, vol. 34, no. 4, 2025, pp. 294-306. doi:10.5114/ppn.2025.156790.

Vancouver

Rzepka M, Toś M, Oleksy P, Reclik M, Mularczyk Z, Śmigiel A et al. Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii. 2025;34(4):294-306. doi:10.5114/ppn.2025.156790.

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Purpose
Myelin oligodendrocyte glycoprotein-associated disease (MOGAD) is an autoimmune demyelinating disorder of the central nervous system, presenting as optic neuritis, transverse myelitis, or acute disseminated encephalomyelitis. In 2023, international diagnostic criteria were established, integrating clinical, laboratory, and magnetic resonance imaging (MRI) findings. This narrative review summarizes current knowledge on late-onset MOGAD (LO-MOGAD), emphasizing its distinct clinical features, diagnostic difficulties, and treatment aspects compared to earlier-onset cases.

Case description
A 60-year-old man developed bilateral optic neuritis, tested positive for MOG immunoglobulin G antibodies, and exhibited a demyelinating lesion in the cervical spinal cord. Five years earlier, he experienced progressive binocular vision loss. Brain MRI revealed non-enhancing supratentorial white matter lesions, and spinal MRI showed a lesion from C3-C5. Anti-aquaporin-4 antibodies and oligoclonal bands were absent.

Comment
LO-MOGAD often presents with subacute onset, bilateral optic neuritis, and short-segment myelitis. Age-related comorbidities and inconsistent study protocols complicate diagnosis and management, highlighting the need for age-specific research.

keywords:

myelin oligodendrocyte glycoprotein, neuromyelitis optica spectrum disorders, central nervous system demyelinating diseases, myelin oligodendrocyte glycoprotein associated disease

Late-onset myelin oligodendrocyte glycoprotein antibody-associated disease: an underrecognized entity in clinical practice; what does its course in later life teach us? A case report and narrative review

Michalina Rzepka 1, 2 , Mateusz Toś 1, 2 , Piotr T. Oleksy 3 , Magdalena Reclik 3 , Zuzanna Mularczyk 3 , Aleksandra Śmigiel 3 , Magdalena Błaszczyk 2 , Joanna Siuda 1, 2

myelin oligodendrocyte glycoprotein, neuromyelitis optica spectrum disorders, central nervous system demyelinating diseases, myelin oligodendrocyte glycoprotein associated disease

Michalina Rzepka

^{1, 2}

,

Mateusz Toś

^{1, 2}

,

Piotr T. Oleksy

³

,

Magdalena Reclik

³

,

Zuzanna Mularczyk

³

,

Aleksandra Śmigiel

³

,

Magdalena Błaszczyk

²

,

Joanna Siuda

^{1, 2}