髓鞘少突细胞糖蛋白(MOG)自身免疫。一个案例报告(P5.346)

文摘

目的:目前的自身免疫性MOG视神经脊髓炎neuritis-transverse。背景:Neuromyelitis视(动)是一种自身免疫状况的特点是复发性炎症性攻击存在纵向横向脊髓炎和视神经炎。动与抗体有关aquaporin-4 (AQP4),然而这些抗体在10 - 50 (percnt)的患者都不存在。抗体的发现针对中枢神经系统内的其他目标导致了更好的描述动谱系障碍和区分他们从多发性硬化症。病例报告:一名45岁男性发达对视神经炎的一集。三周后他出现下肢轻瘫,尿潴留和T6感官层次。骨髓炎的临床诊断。最初的脊柱MRI是不起眼的。他使用血浆置换治疗和改善症状。两周后他的左路视神经炎和恶化的下肢轻瘫。 His repeat spine MRI revealed a T2 hyperintensity extending from T3-T12. Brain MRI revealed contrast enhancement in the right optic nerve with no other lesions. Spinal fluid analysis showed elevated protein, normal IgG index and absent oligoclonal bands. AQP4- antibodies were negative in serum and CSF; Anti-MOG antibodies were identified in serum. The patient responded well to plasmapheresis and has remained relapse-free on immunotherapy with rituximab. DISCUSSION: Patients with positive anti-MOG antibodies represent a distinct subgroup within the NMO spectrum disorder. They are typically AQP4-seronegative young males with a monophasic course in which optic neuritis and transverse myelitis occur either simultaneously or sequentially with frequent symptom overlap. Patients respond well to immunotherapy and tend to have less relapses. CONCLUSION: Anti-MOG antibody testing should be obtained in AQP4- seronegative patients with NMO phenotype, as it is useful in identifying patients with demyelinating diseases who are unlikely to have MS and may be helpful in determining prognosis.

披露:巴斯克斯博士做Campo没有披露。Yarza博士没有披露。洛佩兹奇博士没有披露。巴雷特博士没有披露。