Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Fundoscopy, Lymphocyte count, Magnetic resonance imaging, Monocyte count, Myelin oligodendrocyte glycoprotein antibody-associated disease
Clinical narrative: positive for the myelin oligodendrocyte glycoprotein antibody; longitudinally extensive transverse myelitis; Left optic neuritis; This literature-non-study case was reported in a literature article and describes the occurrence of MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY-ASSOCIATED DISEASE ( in a 38-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 prophylaxis.           In April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In April 2021, the patient experienced MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY-ASSOCIATED DISEASE (positive for the myelin oligodendrocyte glycoprotein antibody) (seriousness criteria hospitalization and medically significant), MYELITIS TRANSVERSE (longitudinally extensive transverse myelitis) (seriousness criteria hospitalization and medically significant) and OPTIC NEURITIS (Left optic neuritis) (seriousness criteria hospitalization and medically significant). The patient was treated with METHYLPREDNISOLONE (intravenous) at a dose of 1000 milligram. At the time of the report, MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY-ASSOCIATED DISEASE (positive for the myelin oligodendrocyte glycoprotein antibody), MYELITIS TRANSVERSE (longitudinally extensive transverse myelitis) and OPTIC NEURITIS (Left optic neuritis) had resolved with sequelae.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Antibody test: (Negative) aquaporin-4 (AQP-4) was negative. In 2021, Basophil count: 3 %. In 2021, Blood glucose: 72 mg/dl. In 2021, CSF cell count: 52 mg/dl elevated protein. In 2021, Eosinophil count: 12 %. In 2021, Fundoscopy: Normal. In 2021, Lymphocyte count: 78 % no oligoclonal bands. In 2021, Magnetic resonance imaging: Revealed enhancement involving the intraorbital segment of the left optic nerve. MRI of the cervical and thoracic spine revealed multifocal longitudinal areas of T2 hyperintense signal associated with gadolinium enhancement. In 2021, Monocyte count: 7 %. In 2021, Neurological examination: revealed left color desaturation with relative afferent pupillary defect, mild bilateral LE weakness, and sensory deficit to light touch, vibration, and temperature with pin sensory level at T10. In 2021, Protein total: 52 mg/dl. In 2021, Red blood cell count: 3 cells per microlitre. In 2021, SARS-CoV-2 test: (Negative) Negative. In 2021, Visual acuity tests: 20/20 in the right eye and 20/30 in the left eye. In 2021, White blood cell count: 17.88 thousand per cubic millimetre and 215 cells per microlitre.     The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY-ASSOCIATED DISEASE (positive for the myelin oligodendrocyte glycoprotein antibody), MYELITIS TRANSVERSE (longitudinally extensive transverse myelitis) and OPTIC NEURITIS (Left optic neuritis) to be related.    Patient had no family history of autoimmune disorders and concomitant medication list was not provided. Patient was started on plasmapheresis for five sessions with modest improvement of symptoms. Patient was discharged on an oral prednisone taper and reported left blurred vision, lower extremity (LE) weakness/paresthesia and bowel/bladder dysfunction. It was stated that serum myelin oligodendrocyte glycoprotein (MOG) antibody was positive with a titer of 1:1000 (performed through fluorescence activated cell sorting assay). Patient Oligoclonal bands was absent with IgG Index 0.49 Company comment: This is a literature-non-study case concerning a 38-year-old male patient with no medical history, who experienced the serious unexpected events myelitis transverse and optic neuritis reported as a myelin oligodendrocyte glycoprotein antibody - associated disease. Patient developed left blurry vision, lower extremity weakness/paresthesia, and bowel/bladder dysfunction three days after receiving  the first dose of mRNA-1273. MRI of the orbits revealed enhancement involving the intraorbital segment of the left optic nerve, MRI of the cervical and thoracic spine revealed multifocal longitudinal areas of T2 hyperintense signal associated with gadolinium enhancement. CSF analysis revealed elevated protein (52 mg/dL) and WBC (215 cells/uL, 78% lymphocytes with no oligoclonal bands) and aquaporin-4 was negative. He was diagnosed with left optic neuritis and longitudinally extensive transverse myelitis; tested positive for the myelin oligodendrocyte glycoprotein antibody.  He was treated with IV methylprednisolone 1000 mg for 5 days. Due to minimal response on the third day of steroids, he was started on plasmapheresis for five sessions.  He was discharged on an oral prednisone taper. In follow up visit two months later, he reported residual LE weakness and bladder dysfunction. The benefit-risk relationship of mRNA-1273 is not affected by this report.   Most recent FOLLOW-UP information incorporated above includes: On 07-Jul-2022: Live Follow up received by safety on 07-JUL-2022 has email which contains significant information: lab data, events and clinical course details updated.; Sender's Comments: Company comment: This is a literature-non-study case concerning a 38-year-old male patient with no medical history, who experienced the serious unexpected events myelitis transverse and optic neuritis reported as a myelin oligodendrocyte glycoprotein antibody - associated disease. Patient developed left blurry vision, lower extremity weakness/paresthesia, and bowel/bladder dysfunction three days after receiving  the first dose of mRNA-1273. MRI of the orbits revealed enhancement involving the intraorbital segment of the left optic nerve, MRI of the cervical and thoracic spine revealed multifocal longitudinal areas of T2 hyperintense signal associated with gadolinium enhancement. CSF analysis revealed elevated protein (52 mg/dL) and WBC (215 cells/uL, 78% lymphocytes with no oligoclonal bands) and aquaporin-4 was negative. He was diagnosed with left optic neuritis and longitudinally extensive transverse myelitis; tested positive for the myelin oligodendrocyte glycoprotein antibody.  He was treated with IV methylprednisolone 1000 mg for 5 days. Due to minimal response on the third day of steroids, he was started on plasmapheresis for five sessions.  He was discharged on an oral prednisone taper. In follow up visit two months later, he reported residual LE weakness and bladder dysfunction. The benefit-risk relationship of mRNA-1273 is not affected by this report.