成人MOG抗体相关疾病二例  

Two cases of adult MOG-IgG associated diseases

作　　者：薛卫红 李滢 王力娜[1] 苗江永[1] 张祥建[1] Xue Weihong;Li Ying;Wang Lina;Miao Jiangyong;Zhang Xiangjian(Department of Neurology,Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经内科,石家庄050000

出　　处：《脑与神经疾病杂志》2023年第3期155-160,共6页Journal of Brain and Nervous Diseases

基　　金：国家自然科学基金会项目(81571292)。

摘　　要：目的讨论并总结髓鞘少突胶质细胞糖蛋白(MOG)抗体相关疾病的临床表现、影像学表现及治疗,为该类疾病的诊疗提供参考。方法报道2例成人MOG抗体相关疾病病历并分析。结果2例成人MOG抗体相关疾病均以头晕为首发临床症状,例1首次发作表现为双侧脑炎合并癫痫发作,复发表现为视神经脊髓炎。例2表现为逐渐进展的脑脊髓炎。本文2例急性期给予小剂量激素治疗后症状均得到明显缓解。搜索既往MOG抗体相关疾病报道,其中以视神经脊髓炎、横贯性脊髓炎等常见,治疗方法主要是激素冲击结合免疫治疗。结论目前MOG抗体相关疾病临床表现和影像学缺乏特异性,且存在影像学滞后于临床表现的情况。因此,对于临床表现或影像学不典型的患者,及早识别、及时治疗是关键。对于部分患者,急性期小剂量激素治疗也可得到临床获益。Objective o discuss and summarize the clinical characteristics,imaging manifestation and treatment of MOG antibody associated diseases.Methods Two cases of adult MOG antibody associated diseases were reported and the relevant literature was reviewed and analyzed.Results Dizziness was the first clinical symptom in both cases.The first attack of case 1 was bilateral encephalitis combined with seizures,the recurrence was optic neuromyelitis,case 2 was progressive encephalomyelitis,and the MOG antibodies were positive in serum and cerebrospinal fluid.The symptoms were significantly relieved after low-dose hormone treatment.Among the previous related cases,cases of optic neuromyelitis,transverse myelitis are common.The main treatment is hormone combined with immunotherapy.Conclusion The clinical and imaging manifestations of MOG antibody related diseases are lack of specificity,and the imaging manifestations lag behind the clinical manifestations.Therefore,for patients with atypical clinical or imaging manifestations,early identification and timely treatment are the keys.For some patients,low-dose steroid therapy in the acute phase may also provide clinical benefit.

关 键 词：髓鞘少突胶质细胞糖蛋白 脱髓鞘疾病 MOG抗体相关疾病 双侧脑炎 脑脊髓炎 

分 类 号：R741.05[医药卫生—神经病学与精神病学]