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[A case of anti-myelin oligodendrocyte glycoprotein (MOG) and anti-N-methyl-D-aspartate (NMDA) receptor antibody-positive encephalitis with optic neuritis].
Rinsho Shinkeigaku. 2018 Oct 24; 58(10):636-641.RS

Abstract

A 20-year-old female was hospitalized due to generalized seizure two weeks after an infection. She reported disorientation, neck stiffness and weakness in her legs. MRI FLAIR images and T2WI on her first visit to our hospital showed hyperintense lesions in the bilateral cingulate gyrus and the medial region of the superior frontal gyrus. Gadolinium (Gd)-enhanced T1WI showed enhancement in the upper part of the corpus callosum. Examination of her cerebrospinal fluid (CSF) revealed mildly elevated leucocytes. After the administration of high-dose intravenous methylprednisolone, her symptoms partially improved. However, MRI T2WI at 16 days after admission showed a lesion with a peripheral hypointense rim in the left side of the cingulate gyrus, which had ring enhancement on contrast CT. FLAIR images at 28 days after admission showed the hyperintense lesion spreading in the subcallosal area and the brainstem, and coronal short inversion time inversion recovery (STIR) images demonstrated bilateral optic neuritis. She was treated with steroid pulse therapy and plasma exchange. Thereafter her symptoms improved. The patient's CSF at 27 days after admission tested positive for anti-myelin oligodendrocyte glycoprotein (anti-MOG) antibodies and anti-N-methyl-D-aspartate (anti-NMDA) receptor antibodies. Encephalitis with optic neuritis in a patient with both anti-MOG and anti-NMDA receptor antibodies is very rare. Coexistence of multiple antibodies in the same patient may contribute to the diversity of autoimmune diseases associated with anti-MOG antibodies or anti-NMDA receptor antibodies.

Authors+Show Affiliations

Department of Neurology, National Hospital Organization Beppu Medical Center.Department of Neurology, National Hospital Organization Beppu Medical Center.Department of Neurology, National Hospital Organization Beppu Medical Center.

Pub Type(s)

Case Reports
Journal Article

Language

jpn

PubMed ID

30270341

Citation

Nagata, Satoshi, et al. "[A Case of Anti-myelin Oligodendrocyte Glycoprotein (MOG) and anti-N-methyl-D-aspartate (NMDA) Receptor Antibody-positive Encephalitis With Optic Neuritis]." Rinsho Shinkeigaku = Clinical Neurology, vol. 58, no. 10, 2018, pp. 636-641.
Nagata S, Nishimura Y, Mitsuo K. [A case of anti-myelin oligodendrocyte glycoprotein (MOG) and anti-N-methyl-D-aspartate (NMDA) receptor antibody-positive encephalitis with optic neuritis]. Rinsho Shinkeigaku. 2018;58(10):636-641.
Nagata, S., Nishimura, Y., & Mitsuo, K. (2018). [A case of anti-myelin oligodendrocyte glycoprotein (MOG) and anti-N-methyl-D-aspartate (NMDA) receptor antibody-positive encephalitis with optic neuritis]. Rinsho Shinkeigaku = Clinical Neurology, 58(10), 636-641. https://doi.org/10.5692/clinicalneurol.cn-001194
Nagata S, Nishimura Y, Mitsuo K. [A Case of Anti-myelin Oligodendrocyte Glycoprotein (MOG) and anti-N-methyl-D-aspartate (NMDA) Receptor Antibody-positive Encephalitis With Optic Neuritis]. Rinsho Shinkeigaku. 2018 Oct 24;58(10):636-641. PubMed PMID: 30270341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A case of anti-myelin oligodendrocyte glycoprotein (MOG) and anti-N-methyl-D-aspartate (NMDA) receptor antibody-positive encephalitis with optic neuritis]. AU - Nagata,Satoshi, AU - Nishimura,Yuji, AU - Mitsuo,Kunihiko, Y1 - 2018/09/29/ PY - 2018/10/3/pubmed PY - 2018/11/15/medline PY - 2018/10/2/entrez KW - anti-MOG antibody KW - anti-NMDA receptor antibody KW - encephalitis KW - optic neuritis SP - 636 EP - 641 JF - Rinsho shinkeigaku = Clinical neurology JO - Rinsho Shinkeigaku VL - 58 IS - 10 N2 - A 20-year-old female was hospitalized due to generalized seizure two weeks after an infection. She reported disorientation, neck stiffness and weakness in her legs. MRI FLAIR images and T2WI on her first visit to our hospital showed hyperintense lesions in the bilateral cingulate gyrus and the medial region of the superior frontal gyrus. Gadolinium (Gd)-enhanced T1WI showed enhancement in the upper part of the corpus callosum. Examination of her cerebrospinal fluid (CSF) revealed mildly elevated leucocytes. After the administration of high-dose intravenous methylprednisolone, her symptoms partially improved. However, MRI T2WI at 16 days after admission showed a lesion with a peripheral hypointense rim in the left side of the cingulate gyrus, which had ring enhancement on contrast CT. FLAIR images at 28 days after admission showed the hyperintense lesion spreading in the subcallosal area and the brainstem, and coronal short inversion time inversion recovery (STIR) images demonstrated bilateral optic neuritis. She was treated with steroid pulse therapy and plasma exchange. Thereafter her symptoms improved. The patient's CSF at 27 days after admission tested positive for anti-myelin oligodendrocyte glycoprotein (anti-MOG) antibodies and anti-N-methyl-D-aspartate (anti-NMDA) receptor antibodies. Encephalitis with optic neuritis in a patient with both anti-MOG and anti-NMDA receptor antibodies is very rare. Coexistence of multiple antibodies in the same patient may contribute to the diversity of autoimmune diseases associated with anti-MOG antibodies or anti-NMDA receptor antibodies. SN - 1882-0654 UR - https://www.unboundmedicine.com/medline/citation/30270341/[A_case_of_anti_myelin_oligodendrocyte_glycoprotein__MOG__and_anti_N_methyl_D_aspartate__NMDA__receptor_antibody_positive_encephalitis_with_optic_neuritis]_ L2 - https://dx.doi.org/10.5692/clinicalneurol.cn-001194 DB - PRIME DP - Unbound Medicine ER -