Kadam Rochita, Fathalla Waseem, Hosain Syed A, Al BinAli Reem
Pediatrics, Sheikh Shakhbout Medical City, Abu Dhabi, ARE.
Pediatric Neurology, Sheikh Shakhbout Medical City, Abu Dhabi, ARE.
Cureus. 2023 Aug 9;15(8):e43218. doi: 10.7759/cureus.43218. eCollection 2023 Aug.
We present a case of an eight-year-old boy who presented with complaints of headache, blurry vision, and eye pain. Ophthalmological exams and magnetic resonance imaging confirmed the presence of optic neuritis. Initial cerebrospinal fluid analysis was negative for all antibodies (Abs) associated with optic neuritis and other acute demyelinating syndromes, including anti-myelin oligodendrocyte glycoprotein Ab (anti-MOG-Ab). The child was treated with a course of pulse methylprednisolone therapy for five days, with significant improvement in his symptoms. However, the child went on to have a recurrent episode of optic neuritis one month after his initial presentation. Hence, investigations targeting immunological biomarkers were repeated and turned out to be positive for anti-MOG-Abs with elevated titers. The child was diagnosed with MOG-Ab-associated optic neuritis presenting as chronic relapsing inflammatory optic neuropathy (CRION). He was then started on maintenance intravenous immunoglobulin (IVIG) therapy as a disease-modifying therapy, following which he has not had any further relapses over two years.
我们报告一例8岁男孩，他主诉头痛、视力模糊和眼痛。眼科检查和磁共振成像证实存在视神经炎。最初的脑脊液分析显示，与视神经炎和其他急性脱髓鞘综合征相关的所有抗体（Abs）均为阴性，包括抗髓鞘少突胶质细胞糖蛋白抗体（抗MOG-Ab）。该患儿接受了为期5天的脉冲甲基强的松龙治疗，症状有显著改善。然而，该患儿在首次就诊后1个月出现了复发性视神经炎。因此，针对免疫生物标志物的检查再次进行，结果显示抗MOG-Abs呈阳性且滴度升高。该患儿被诊断为与MOG-Ab相关的视神经炎，表现为慢性复发性炎症性视神经病变（CRION）。随后，他开始接受维持性静脉注射免疫球蛋白（IVIG）治疗作为疾病改善疗法，此后两年内他未再复发。
