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一例被诊断为脑梗死或髓鞘少突胶质细胞糖蛋白抗体相关疾病的疑难病例。

A Confused Case Diagnosed as Cerebral Infarction or Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.

作者信息

Ding Yanan, Zhang Li, Huang Anqi, Meng Xianyue, Li Xueli

机构信息

Department of Neurology Liaocheng Hospital Affiliated to Shandong First Medical University (Liaocheng People's Hospital), Liaocheng 252000, Shandong, China.

出版信息

Case Rep Neurol Med. 2024 Aug 23;2024:9941341. doi: 10.1155/2024/9941341. eCollection 2024.

Abstract

In order to discuss the clinical and MRI features, diagnosis, and prevention of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), we reported an adult case of MOG antibody-related disease misdiagnosed as cerebral infarction. This patient's first clinical symptom was limb weakness, that different from previous reports of MOG antibody-related diseases, such as brainstem encephalitis, neuromyelitis optical, and transverse myelitis. The main treatment plan is high-dose corticosteroid therapy combined with immunoglobulin therapy. This case indicated that some MOGAD patients lack of specificity in the clinical manifestations and imaging perhaps would be misdiagnosed as cerebral infarction, encephalitis, immune peripheral neuropathy, MS, NMOSD, and other diseases. For patients with atypical clinical manifestations or imaging, it is especially important to take antibody detection as early as possible to make correct diagnosis and active treatment in time to avoid disability.

摘要

为探讨髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)的临床及MRI特征、诊断及预防,我们报告1例被误诊为脑梗死的成人MOG抗体相关疾病病例。该患者的首发临床症状为肢体无力,这与既往报道的MOG抗体相关疾病如脑干脑炎、视神经脊髓炎及横贯性脊髓炎不同。主要治疗方案为大剂量糖皮质激素治疗联合免疫球蛋白治疗。该病例提示,部分MOGAD患者临床表现及影像学缺乏特异性,可能会被误诊为脑梗死、脑炎、免疫性周围神经病、多发性硬化、视神经脊髓炎谱系疾病等。对于临床表现或影像学不典型的患者,尽早进行抗体检测以做出正确诊断并及时积极治疗以避免残疾尤为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcdc/11364470/479b6964ddf8/CRINM2024-9941341.001.jpg

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