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一名儿科患者的髓鞘少突胶质细胞糖蛋白抗体病病例:临床表现、治疗反应及随访注意事项

A Case of Myelin Oligodendrocyte Glycoprotein Antibody Disease in a Pediatric Patient: Clinical Presentation, Treatment Response, and Follow-Up Considerations.

作者信息

Elashmawy Ahmed, Haq Anas, Sharif Saima, Dazy Kevin

机构信息

Pediatrics, Wayne State University School of Medicine, Detroit, USA.

Pediatrics, Children's Hospital of Michigan, Detroit, USA.

出版信息

Cureus. 2024 Sep 30;16(9):e70518. doi: 10.7759/cureus.70518. eCollection 2024 Sep.

Abstract

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a rare autoimmune demyelinating disorder that targets the central nervous system and is characterized by antibodies that act against myelin oligodendrocyte glycoprotein (MOG). This disorder typically manifests with symptoms such as optic neuritis, transverse myelitis, or encephalitis, leading to symptoms such as vision loss, muscle weakness, sensory disturbances, and cognitive impairment. We present the case of a 10-year-old male who was eventually diagnosed with MOGAD after consideration of several other neurological and musculoskeletal disorders, who was admitted to the hospital due to an initial presentation of urinary retention and pelvic pain. The patient's clinical course included an MRI scan showing extensive demyelinating lesions in the spinal cord, along with positive MOG antibody serology. Management involved a multidisciplinary approach, including consultations from neurology, physical therapy, and the general pediatrics team, as well as administration of high-dose corticosteroids. This case underscores the importance of early recognition and aggressive treatment of MOGAD, a disorder that can present similarly to other demyelinating diseases such as multiple sclerosis and neuromyelitis optica spectrum disorder, with the distinguishing feature of MOGAD being the presence of antibodies against MOG.

摘要

髓鞘少突胶质细胞糖蛋白抗体病(MOGAD)是一种罕见的自身免疫性脱髓鞘疾病,以中枢神经系统为靶点,其特征是存在针对髓鞘少突胶质细胞糖蛋白(MOG)的抗体。这种疾病通常表现为视神经炎、横贯性脊髓炎或脑炎等症状,导致视力丧失、肌肉无力、感觉障碍和认知障碍等。我们报告一例10岁男性病例,该患者在排除了其他几种神经和肌肉骨骼疾病后最终被诊断为MOGAD,他因最初出现尿潴留和盆腔疼痛而入院。患者的临床病程包括MRI扫描显示脊髓广泛脱髓鞘病变,以及MOG抗体血清学检测呈阳性。治疗采用多学科方法,包括神经内科、物理治疗和普通儿科团队的会诊,以及大剂量皮质类固醇的使用。该病例强调了早期识别和积极治疗MOGAD的重要性,MOGAD可能与其他脱髓鞘疾病如多发性硬化症和视神经脊髓炎谱系障碍表现相似,而MOGAD的独特特征是存在针对MOG的抗体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e5/11524172/d6fe1a1c00da/cureus-0016-00000070518-i01.jpg

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