Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China.
Front Immunol. 2022 Apr 14;13:832084. doi: 10.3389/fimmu.2022.832084. eCollection 2022.
Herein, we reported a case of a young man diagnosed with MNOS (anti-myelin oligodendrocyte glycoprotein associated disease (MOGAD) and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis overlapping syndrome, i.e., MNOS), whose imaging findings in magnetic resonance imaging (MRI) mimicked chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). We reported a case of refractory anti-NMDAR encephalitis that recurred after standard first-line and second-line treatment. The patient presented with CLIPPERS on imaging at recent hospital admission, and his MOG antibodies were seropositive. After intravenous methylprednisolone (IVMP) treatment, the patient's symptoms were significantly alleviated. In this case, we demonstrated that MNOS could mimic the radiological characteristics of CLIPPERS. Future studies should focus on the diagnosis and treatment of antibody overlap syndrome.
在此,我们报告了一例年轻男性患者被诊断为 MNOS(抗髓鞘少突胶质细胞糖蛋白相关疾病(MOGAD)和抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎重叠综合征,即 MNOS),其磁共振成像(MRI)的影像学表现类似于对类固醇有反应的慢性淋巴细胞性炎症伴脑桥血管周围增强(CLIPPERS)。我们报告了一例难治性抗 NMDAR 脑炎,该患者在标准一线和二线治疗后复发。该患者最近入院时的影像学表现为 CLIPPERS,其 MOGA 抗体呈阳性。经静脉注射甲基强的松龙(IVMP)治疗后,患者的症状明显缓解。在本例中,我们证实 MNOS 可能模拟 CLIPPERS 的影像学特征。未来的研究应侧重于抗体重叠综合征的诊断和治疗。