Ataka Takuya, Kimura Noriyuki, Matsubara Etsuro
Department of Neurology, Faculty of Medicine, Oita University.
Department of Neurology, Faculty of Medicine, Oita University.
Mult Scler Relat Disord. 2020 Aug;43:102191. doi: 10.1016/j.msard.2020.102191. Epub 2020 May 23.
We report the case of a patient with myelin oligodendrocyte glycoprotein (MOG)- antibody-associated disease presenting with tumefactive demyelinating lesion. Neurological examination showed aphasia, acalculia, agraphia, alexia, left-right disorientation, and right hemiplegia. Brain magnetic resonance imaging revealed a large monofocal lesion with mild brain edema and ring enhancement. Stereotactic brain biopsy was performed, and neuropathological findings showed inflammatory demyelination and preserved axons without tumor cells. A cell-based assay detected anti-MOG antibody in the cerebrospinal fluid. Neurological symptoms gradually improved after steroid pulse therapy. MOG-antibody-associated diseases should be considered in the differential diagnosis of tumefactive demyelinating lesion.
我们报告了一例患有髓鞘少突胶质细胞糖蛋白（MOG）抗体相关疾病并伴有肿胀性脱髓鞘病变的患者。神经系统检查显示失语、失算、失写、失读、左右定向障碍和右侧偏瘫。脑磁共振成像显示一个大的单发病灶，伴有轻度脑水肿和环形强化。进行了立体定向脑活检，神经病理学结果显示炎性脱髓鞘且轴突保留，无肿瘤细胞。基于细胞的检测在脑脊液中检测到抗MOG抗体。类固醇脉冲治疗后神经症状逐渐改善。在肿胀性脱髓鞘病变的鉴别诊断中应考虑MOG抗体相关疾病。
