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视神经脊髓炎谱系障碍和髓鞘少突胶质细胞糖蛋白脑病的诊断与治疗

Diagnosis and Treatment of NMO Spectrum Disorder and MOG-Encephalomyelitis.

作者信息

Borisow Nadja, Mori Masahiro, Kuwabara Satoshi, Scheel Michael, Paul Friedemann

机构信息

NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.

出版信息

Front Neurol. 2018 Oct 23;9:888. doi: 10.3389/fneur.2018.00888. eCollection 2018.

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) are autoantibody mediated chronic inflammatory diseases. Serum antibodies (Abs) against the aquaporin-4 water channel lead to recurrent attacks of optic neuritis, myelitis and/or brainstem syndromes. In some patients with symptoms of NMOSD, no AQP4-Abs but Abs against myelin-oligodendrocyte-glycoprotein (MOG) are detectable. These clinical syndromes are now frequently referred to as "MOG-encephalomyelitis" (MOG-EM). Here we give an overview on current recommendations concerning diagnosis of NMOSD and MOG-EM. These include antibody and further laboratory testing, MR imaging and optical coherence tomography. We discuss therapeutic options of acute attacks as well as longterm immunosuppressive treatment, including azathioprine, rituximab, and immunoglobulins.

摘要

视神经脊髓炎谱系障碍(NMOSD)是自身抗体介导的慢性炎症性疾病。针对水通道蛋白4水通道的血清抗体可导致视神经炎、脊髓炎和/或脑干综合征反复发作。在一些有NMOSD症状的患者中,检测不到抗水通道蛋白4抗体(AQP4-Abs),但可检测到抗髓鞘少突胶质细胞糖蛋白(MOG)的抗体。这些临床综合征现在常被称为“MOG脑脊髓炎”(MOG-EM)。在此,我们概述了目前关于NMOSD和MOG-EM诊断的建议。这些建议包括抗体及其他实验室检测、磁共振成像和光学相干断层扫描。我们讨论了急性发作的治疗选择以及长期免疫抑制治疗,包括硫唑嘌呤、利妥昔单抗和免疫球蛋白。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56bc/6206299/9da41b979e18/fneur-09-00888-g0001.jpg

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