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Perivascular enhancement in anti-MOG antibody demyelinating disease of the CNS
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    Brain perivascular enhancement: MOG or GFAP- antibody related?
    • DIMITRIOS PARISSIS, Clinical Neurologist Aristotle University of Thessaloniki, B' Department of Neurology, AHEPA Hospital
    • Other Contributors:
      • PANOS IOANNIDIS, Clinical Neurologist

    Komatsu et al. presented an interesting clinicopathological case of anti-myelin oligodendrocyte glycoprotein (MOG) demyelinating disease of the CNS. (1) Their patient had a rather unusual subacute encephalopathic presentation with extensive supratentorial fluid-attenuation inversion recovery white matter hyperintensities. The authors focused mainly on the conspicuous MRI punctuate and curvilinear enhancement pattern within the hemispheric lesions.
    It is well established that intraparenchymal punctuate and curvilinear gadolinium enhancement may arise in the context of Moyamoya syndrome, various endotheliopathies and most commonly, in disorders causing small vessels blood-brain barrier disruption. (2)These entities are associated histologically with perivascular cellular infiltrates and include inflammatory autoimmune diseases (i.e. primary or secondary angiitis of the CNS, neurosarcoidosis, histiocytosis and demyelinating diseases of the CNS), pre-lymphoma states (i.e. sentinel lesions of primary CNS lymphoma), non-Hodgkin lymphoma (i.e. intravascular lymphoma) and CLIPPERS syndrome. (2) Notably, among demyelinating disorders, multiple sclerosis and aquaporin-4 antibody (AQP4-Ab) neuromyelitis optica spectrum disorders (NMOSD) manifest this specific neuroimaging pattern in rare cases. (2,3)
    We agree with Komatsu et al. that their case is the first report of the perivascular enhancement in anti-MOG antibody disease. Indeed, gadolinium enhancement was observed in...

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    Conflict of Interest:
    None declared.