Myelin oligodendrocyte glycoprotein antibody-associated disease manifesting as intractable fever managed by bromocriptine: a case report

Background: Demyelinating events expressed as abnormal thermoregulatory responses are rare, but intractable fever in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is very rarely reported.Case Report: A 56-year-old woman presented with quadriparesis with acroparesthesia. During the admission, fever developed and persisted for 2 days despite the administration of high-dose antipyretics. Brain magnetic resonance imaging (MRI) showed hyperintense lesions involving the upper brainstem. A diagnosis of MOGAD was made according to the clinical characteristics and presence of seropositive MOG antibody. After administration of oral bromocriptine (2.5 mg/day), fever was slowly controlled for a few days.Conclusion: The present case explained that persistent fever in MOGAD could manifest as an uncommon manifestation. The lesion in the upper brainstem within the brain MRI could be thought of as a lesion anterior to the periaqueductal gray and the lesion at that site could be the cause of the patient's persistent fever with unknown origin.