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冻融胚胎移植后出现的原发性髓鞘少突胶质细胞糖蛋白-免疫球蛋白G相关视神经炎

Primary Myelin Oligodendrocyte Glycoprotein-Immunoglobulin G-associated Optic Neuritis Presenting after a Frozen Embryo Transfer.

作者信息

Siegel Dana Rebecca, Luu Thanh-Ha, Skaznik-Wikiel Malgorzata E

机构信息

Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

J Hum Reprod Sci. 2021 Apr-Jun;14(2):203-205. doi: 10.4103/jhrs.jhrs_30_21. Epub 2021 Jun 28.

Abstract

Myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G-associated optic neuritis (ON) is a newly recognized antibody-mediated demyelinating disease of the central nervous system, resulting in acute visual loss and pain with eye movement. The effects of pregnancy on disease pathogenesis remain incompletely understood. Herein, we present a novel association between a frozen embryo transfer (FET) and the first manifestation of MOG-ON in a previously healthy patient with unexplained infertility. The patient presented with acute bilateral visual loss 3 weeks after a single FET and was found to test positive for MOG antibodies with an otherwise unremarkable workup. The patient's vision returned to baseline with high-dose intravenous methylprednisolone and therapeutic plasma exchange. This is the first published case highlighting an association between MOG-ON and assisted reproductive technology (ART) in a patient without prior risk factors. Further studies are needed to clarify the effects of ART and pregnancy in general on disease pathogenesis.

摘要

髓鞘少突胶质细胞糖蛋白(MOG)-免疫球蛋白G相关视神经炎(ON)是一种新认识的中枢神经系统抗体介导的脱髓鞘疾病,可导致急性视力丧失和眼球运动时疼痛。妊娠对疾病发病机制的影响仍未完全明确。在此,我们报告了一例冻融胚胎移植(FET)与一名既往健康的不明原因不孕症患者首次出现MOG-ON之间的新关联。该患者在单次FET后3周出现急性双侧视力丧失,经检查发现MOG抗体呈阳性,其他检查未见异常。患者接受大剂量静脉注射甲泼尼龙和治疗性血浆置换后视力恢复至基线水平。这是首例发表的病例,突出了在无既往危险因素的患者中MOG-ON与辅助生殖技术(ART)之间的关联。需要进一步研究以阐明ART及一般妊娠对疾病发病机制的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22d0/8279048/3bd7b8db483a/JHRS-14-203-g001.jpg

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