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  • Anti-MOG autoantibody-associated schizophreniform psychosis

  • Katharina von Zedtwitz, Isabelle Matteit, Maike Michel, Bernd Feige, Kimon Runge, Dominik Denzel, Andrea Schlump, Kathrin Nickel, Miriam A. Schiele, Benjamin Berger, Harald Prüss, Horst Urbach, Katharina Domschke, Ludger Tebartz van Elst, Dominique Endres
  • Journal:
    Acta Neuropsychiatrica / Volume 34 / Issue 1 / February 2022
    Published online by Cambridge University Press:
    08 September 2021, pp. 47-54
    • Article
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  • Objectives:

    Autoimmune mechanisms are related to disease development in a subgroup of patients with psychosis. The contribution of immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein (MOG) is mainly unclear in this context.

    Methods:

    Therefore, two patients with psychosis and anti-MOG antibodies – detected in fixed cell-based and live cell-based assays – are presented.

    Results:

    Patient 1 suffered from late-onset psychosis with singular white matter lesions in magnetic resonance imaging (MRI) and intermittent electroencephalography (EEG) slowing. Patient 2 suffered from a chronic paranoid–hallucinatory disorder with intermittent confusional states, non-specific white matter alterations on MRI, a disorganised alpha rhythm on EEG, and elevated cerebrospinal fluid protein. Both patients had anti-MOG antibody titres of 1 : 320 in serum (reference < 1 : 20).

    Conclusions:

    The arguments for and against a causal role for anti-MOG antibodies are discussed. The antibodies could be relevant, but due to moderate titres, they may have caused a rather ‘subtle clinical picture’ consisting of psychosis instead of ‘classical’ MOG encephalomyelitis.