AUTHOR=Takahashi Keita , Takeuchi Hideyuki , Fukai Ryoko , Nakamura Haruko , Morihara Keisuke , Higashiyama Yuichi , Takahashi Toshiyuki , Doi Hiroshi , Tanaka Fumiaki TITLE=Case Report: Anti-MOG Antibody Seroconversion Accompanied by Dimethyl Fumarate Treatment JOURNAL=Frontiers in Immunology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.625465 DOI=10.3389/fimmu.2021.625465 ISSN=1664-3224 ABSTRACT=

Here we report three cases of anti-myelin oligodendrocyte glycoprotein (MOG) antibody–associated disease (MOGAD) mimicking multiple sclerosis in which seropositivity for anti-MOG antibodies occurred during disease-modifying drug dimethyl fumarate (DMF) treatment. These patients developed relapses with anti-MOG antibody seroconversion after switching from fingolimod or steroid pulse therapy to DMF, which was associated with peripheral lymphocyte recovery. MOGAD is considered a humoral immune disease, and DMF reportedly enhances Th2-skewed humoral immune activity. Therefore, we suggest that DMF, but not fingolimod, may exacerbate humoral immune imbalance and enhance autoantibody production, leading to aggravation of MOGAD.