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Clinical analysis of a patient simultaneously positive for antibodies of myelin oligodendrocyte glycoprotein and anti-N-methyl-D-aspartate receptor: A case report.
Medicine (Baltimore). 2021 Jan 08; 100(1):e24234.M

Abstract

RATIONALE

Myelin oligodendrocyte glycoprotein (MOG) antibody (MOG-Ab) disease (MOG-AD) is a type of demyelinating disease of the central nervous system characterized by a high frequency of optic neuritis (ON) attacks. anti-Nmethyl-D-aspartate receptor (NMDAR) encephalitis (anti-NMDARe) is an autoimmune disorder characterized by memory deficits, conscious disturbance, and seizures. Cases of simultaneous occurrence of MOG-Ab and anti-NMDARe antibody (anti-NMDARe-Ab) are rarely reported and could be mistaken for overlapping MOG-antibody disease (MOG-AD) and NMDARe. The diagnosis of such patients is challenging.

PATIENT CONCERNS

We report the case of a 37-year-old man who presented with recurrent headaches for 3 months and worsening symptoms over 2 weeks. He had a history of ON. He had a generalized seizure after 7 days in the hospital.

DIAGNOSIS

Brain magnetic resonance imaging (MRI) and cerebrospinal fluid tests showed no apparent abnormalities. Repeat MRI showed slight lesions 7 days later, and cerebrospinal fluid tests showed the simultaneous occurrence of MOG-Ab and anti-NMDARe-Ab.

INTERVENTIONS

He completely recovered after treatment with low doses of oral corticosteroids.

OUTCOMES

Two months and 2 years follow-up showed that his condition was stable.

LESSONS

The co-occurrence of MOG-Ab and anti-NMDAR-Ab does not indicate the co-occurrence of MOG-AD and anti-NMDARe. Laboratory findings should be combined with the clinical features to achieve an accurate and suitable diagnosis.

Authors+Show Affiliations

Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University. Department of Neurology, Shenzhen University First Affiliated Hospital.Department of Neurology, Shenzhen University First Affiliated Hospital. Department of Neurology, Shenzhen Second People's Hospital.Department of Gastroenterology, Shenzhen Shiyan People's Hospital, Shenzhen, China.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

33429822

Citation

Cao, Liming, et al. "Clinical Analysis of a Patient Simultaneously Positive for Antibodies of Myelin Oligodendrocyte Glycoprotein and anti-N-methyl-D-aspartate Receptor: a Case Report." Medicine, vol. 100, no. 1, 2021, pp. e24234.
Cao L, Ren L, Huang X. Clinical analysis of a patient simultaneously positive for antibodies of myelin oligodendrocyte glycoprotein and anti-N-methyl-D-aspartate receptor: A case report. Medicine (Baltimore). 2021;100(1):e24234.
Cao, L., Ren, L., & Huang, X. (2021). Clinical analysis of a patient simultaneously positive for antibodies of myelin oligodendrocyte glycoprotein and anti-N-methyl-D-aspartate receptor: A case report. Medicine, 100(1), e24234. https://doi.org/10.1097/MD.0000000000024234
Cao L, Ren L, Huang X. Clinical Analysis of a Patient Simultaneously Positive for Antibodies of Myelin Oligodendrocyte Glycoprotein and anti-N-methyl-D-aspartate Receptor: a Case Report. Medicine (Baltimore). 2021 Jan 8;100(1):e24234. PubMed PMID: 33429822.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical analysis of a patient simultaneously positive for antibodies of myelin oligodendrocyte glycoprotein and anti-N-methyl-D-aspartate receptor: A case report. AU - Cao,Liming, AU - Ren,Lijie, AU - Huang,Xuming, PY - 2020/09/15/received PY - 2020/12/17/accepted PY - 2021/1/12/entrez PY - 2021/1/13/pubmed PY - 2021/1/23/medline SP - e24234 EP - e24234 JF - Medicine JO - Medicine (Baltimore) VL - 100 IS - 1 N2 - RATIONALE: Myelin oligodendrocyte glycoprotein (MOG) antibody (MOG-Ab) disease (MOG-AD) is a type of demyelinating disease of the central nervous system characterized by a high frequency of optic neuritis (ON) attacks. anti-Nmethyl-D-aspartate receptor (NMDAR) encephalitis (anti-NMDARe) is an autoimmune disorder characterized by memory deficits, conscious disturbance, and seizures. Cases of simultaneous occurrence of MOG-Ab and anti-NMDARe antibody (anti-NMDARe-Ab) are rarely reported and could be mistaken for overlapping MOG-antibody disease (MOG-AD) and NMDARe. The diagnosis of such patients is challenging. PATIENT CONCERNS: We report the case of a 37-year-old man who presented with recurrent headaches for 3 months and worsening symptoms over 2 weeks. He had a history of ON. He had a generalized seizure after 7 days in the hospital. DIAGNOSIS: Brain magnetic resonance imaging (MRI) and cerebrospinal fluid tests showed no apparent abnormalities. Repeat MRI showed slight lesions 7 days later, and cerebrospinal fluid tests showed the simultaneous occurrence of MOG-Ab and anti-NMDARe-Ab. INTERVENTIONS: He completely recovered after treatment with low doses of oral corticosteroids. OUTCOMES: Two months and 2 years follow-up showed that his condition was stable. LESSONS: The co-occurrence of MOG-Ab and anti-NMDAR-Ab does not indicate the co-occurrence of MOG-AD and anti-NMDARe. Laboratory findings should be combined with the clinical features to achieve an accurate and suitable diagnosis. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/33429822/Clinical_analysis_of_a_patient_simultaneously_positive_for_antibodies_of_myelin_oligodendrocyte_glycoprotein_and_anti_N_methyl_D_aspartate_receptor:_A_case_report_ L2 - https://doi.org/10.1097/MD.0000000000024234 DB - PRIME DP - Unbound Medicine ER -