当髓鞘少突胶质细胞糖蛋白 (MOG) 抗体病和水通道蛋白 4 (AQP4)-IgG 阳性视神经脊髓炎谱系疾病 (NMOSD) 与抗 N-甲基-D-天冬氨酸 (NMDA) 受体脑炎共存时的比较。
Comparison of myelin oligodendrocyte glycoprotein (MOG)-antibody disease and AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD) when they co-exist with anti-NMDA (N-methyl-D-aspartate) receptor encephalitis.
机构信息
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Mult Scler Relat Disord. 2018 Feb;20:144-152. doi: 10.1016/j.msard.2018.01.007. Epub 2018 Jan 31.
BACKGROUND
Myelin oligodendrocyte glycoprotein (MOG)-antibody (ab) disease and AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD) can co-exist with anti-NMDA (N-methyl-D-aspartate) receptor encephalitis (NMDARe).
OBJECTIVES
To characterize MOG-ab disease and AQP4-IgG-positive NMOSD during NMDARe.
METHODS
We analyzed all the patients with overlapping MOG-ab disease and NMDARe (MNOS) and patients with AQP4-IgG-positive NMOSD and NMDARe (ANOS) in our hospital and compared those data with data from systematically review of previously published reports.
RESULTS
In our cohorts, 11.9% patients with MOG-ab disease and 0.6% patients with NMOSD had overlapping NMDARe (P < 0.01). After treatment with steroids and/or intravenous immunoglobulin (IVIg), the median modified Rankin Scale (mRS) of the MNOS group decreased significantly during attacks associated with or without NMDARe (P < 0.01 for both), while that of the ANOS group did not (attack: P < 0.05; attack associated with NMDARe: P > 0.05). Analyzed together with previously reported cases, 6% patients with MNOS and 40% patients with ANOS also used rituximab or cyclophosphamide after steroids and/or IVIg (P < 0.05) during attacks associated with NMDARe.
CONCLUSION
Compared with NMOSD, MOG-ab disease may more commonly co-exist with NMDARe. MNOS patients respond better to steroids and IVIg than do ANOS patients during attacks associated with NMDARe.
背景
髓鞘少突胶质细胞糖蛋白（MOG）抗体（ab）病和水通道蛋白 4（AQP4）-IgG 阳性视神经脊髓炎谱系疾病（NMOSD）可与抗 N-甲基-D-天冬氨酸（NMDA）受体脑炎（NMDARe）共存。
目的
描述 NMDARe 期间 MOG-ab 病和 AQP4-IgG 阳性 NMOSD 的特征。
方法
我们分析了我院重叠 MOG-ab 病和 NMDARe（MNOS）患者以及 AQP4-IgG 阳性 NMOSD 和 NMDARe（ANOS）患者，并与之前发表的综述报告中的数据进行比较。
结果
在我们的队列中，11.9%的 MOG-ab 病患者和 0.6%的 NMOSD 患者存在重叠的 NMDARe（P<0.01）。在接受类固醇和/或静脉注射免疫球蛋白（IVIg）治疗后，MNOS 组在伴有或不伴有 NMDARe 的发作期间，中位数改良 Rankin 量表（mRS）显著降低（两者均 P<0.01），而 ANOS 组的 mRS 无变化（发作时：P<0.05；伴有 NMDARe 的发作时：P>0.05）。与之前报道的病例一起分析，6%的 MNOS 患者和 40%的 ANOS 患者在伴有 NMDARe 的发作期间，也在使用类固醇和/或 IVIg 后使用利妥昔单抗或环磷酰胺（P<0.05）。
结论
与 NMOSD 相比，MOG-ab 病可能更常与 NMDARe 共存。在伴有 NMDARe 的发作期间，MNOS 患者对类固醇和 IVIg 的反应优于 ANOS 患者。
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