因克罗恩病停用免疫抑制治疗而显现的伴有癫痫发作的抗髓鞘少突胶质细胞糖蛋白相关脑炎（FLAMES）中的液体衰减反转恢复序列高信号病变？
FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) unmasked by withdrawal of immunosuppression for Crohn's disease?
作者信息
Stamenova Svetlana, Redha Iman, Schmierer Klaus, Garcia Maria Eugenia
机构信息
Clinical Board Medicine (Neuroscience), Barts Health NHS Trust, The Royal London Hospital, Whitechapel Road, Whitechapel, London E1 1FR, UK; Department of Neurology, Lewisham and Greenwich NHS Trust, Queen Elizabeth Hospital - Stadium Road, London, SE 184Q, UK.
Clinical Board Medicine (Neuroscience), Barts Health NHS Trust, The Royal London Hospital, Whitechapel Road, Whitechapel, London E1 1FR, UK.
出版信息
Mult Scler Relat Disord. 2021 Feb;48:102729. doi: 10.1016/j.msard.2020.102729. Epub 2020 Dec 31.
A 31-year-old pregnant woman presented with headache, fever and left-sided focal motor seizures, which progressed to bilateral tonic-clonic seizures. Her medical history included Crohn's disease treated with azathioprine and adalimumab, which were discontinued when she became pregnant. Her cerebro-spinal fluid was entirely normal and viral PCR negative. Extensive testing for infectious, autoimmune or malignant causes of encephalitis were non-revealing. MRI head showed unilateral cortical FLAIR-hyperintensity which on interval scans was seen bilaterally. Anti-myelin-oligodendrocyte glycoprotein (MOG)-IgG was positive leading to a diagnosis of cortical FLAIR-hyperintense lesions in Anti-MOG-associated Encephalitis with seizures (FLAMES).
一名31岁的孕妇出现头痛、发热和左侧局灶性运动性癫痫发作，随后进展为双侧强直阵挛性癫痫发作。她的病史包括用硫唑嘌呤和阿达木单抗治疗的克罗恩病，怀孕后停用。她的脑脊液完全正常，病毒聚合酶链反应阴性。对脑炎的感染性、自身免疫性或恶性病因进行的广泛检查均未发现异常。头颅磁共振成像显示单侧皮质液体衰减反转恢复序列高信号，在后续扫描中双侧可见。抗髓鞘少突胶质细胞糖蛋白（MOG）-IgG呈阳性，从而诊断为伴有癫痫发作的抗MOG相关脑炎（FLAMES）中的皮质液体衰减反转恢复序列高信号病变。
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