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A 73-year-old man with a 5-day history of continuous hiccup, fever, and rapidly progressing paraplegia was admitted to our hospital. On admission, he exhibited dysarthria, complete paraplegia, and insentience of both lower limbs. Head and spine MRI showed abnormal, asymmetric lesions in the white matter, basal ganglia, and brainstem, and multiple spinal cord lesions. Test for serum anti-AQP4 antibody was negative. Evaluation of human leukocyte antigen (HLA)-B51 was negative; however, HLA-B54 was positive. Although skin lesions were absent, we considered neuro-Sweet disease and high-dose steroid therapy was initiated. The hiccup disappeared gradually, and he regained the ability to walk with a cane 30 days after the onset. Subsequently, the patient tested positive for serum anti-myelin oligodendrocyte glycoprotein (MOG) antibody. It is important to consider MOG antibody-related disease as potential diagnosis in patients exhibiting clinical features of neuro-Sweet disease except for the absence of skin lesions.

rinshō shinkeigaku/rinsho shinkeigaku

A case of anti-myelin oligodendrocyte glycoprotein (MOG) antibody-related disease with human leukocyte antigen (HLA) positivity indicative of neuro-Sweet disease