# Retrospective analysis of the clinical features of 12 cases of MOG antibody-associated aseptic meningitis

## TL;DR

This study examines 12 children with MOG antibody-associated aseptic meningitis, highlighting prolonged fever and inflammatory markers as key clinical features.

## Contribution

The study provides a detailed clinical profile of MOG antibody-associated aseptic meningitis in children, emphasizing its diagnostic challenges.

## Key findings

- All 12 cases presented with prolonged fever and elevated inflammatory markers resembling bacterial infection.
- Cerebrospinal fluid profiles were similar to viral encephalitis, with white blood cell counts ranging from 15 to 182 × 10⁶/L.
- Glucocorticoid therapy normalized body temperatures and inflammatory markers in these children.

## Abstract

In recent years, MOG antibody-associated aseptic meningitis has gradually been reported, but its clinical features are not yet well defined.

A retrospective analysis was conducted on 67 children diagnosed with MOG antibody-associated diseases and treated at the Affiliated Children’s Hospital of Shandong University from January 2021 to June 2024. Out of these cases, 12 exhibited aseptic meningitis. The key features of their clinical manifestations, blood cell analysis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, cerebrospinal fluid (CSF)-related tests, and cranial MRI results were summarized for these 12 cases.

A total of 12 cases (100%) presented with prolonged fever as the main clinical feature. Routine blood tests revealed the following: white blood cell counts ranging from 15.92 to 34.0 × 109/L; neutrophil ratios of 76.5 to 90.3%; ESR ranging from 48 to 105 mm/h; and CRP ranging from 21.6 to 116.0 mg/L. The CSF white blood cell counts ranged from 15 to 182 × 106/L. Cranial MRI revealed inflammatory changes in four cases. The MOG antibody titer was 1:100 in 5 cases, 1:32 in 5 cases, and 1:320 in 2 cases. After glucocorticoid therapy, the body temperatures of these children normalized, and the follow-up routine blood test, CRP, and ESR results gradually returned to the respective normal ranges.

These findings highlight that MOG antibody-associated aseptic meningitis primarily manifests as prolonged fever, with peripheral inflammatory markers that mimic a severe bacterial infection, while CSF profiles resemble those of viral encephalitis. Clinicians should consider MOG antibody-associated disorders in children with unexplained recurrent fever.