摘要
Abstract
Objective To investigate the clinical features of recurrent optic neuromyelitis lineage disease (NMOSD)with anti-myelin oligodendrocyte glycoprotein (MOG)antibody positive after encephalitis.Methods The clinical data of one case of recurrent NMOSD with MOG antibody positive after encephalitis was retrospectively analyzed. Results The first onset age was 11 years and 7 months,the clinical manifestations were headache, seizures,abnormal cranial MRI and CSF. After treatment with acyclovir,methylprednisolone and gamma globulin, the children improved and continued to take prednisone after discharge. One month after discharge,the visual acuity of the right eye of the children decreased,the blood and CSF AQP4-IgG negative,MOG-IgG positive,MRI showed abnormal signals of brain,spinal cord and right optic nerve.After treatment with methylprednisolone,the visual acuity of the children recovered,and the MRI of head and spinal cord were normal,prednisone was taken orally after discharge. Two months after discharge,the visual acuity of the left eye was decreased,the blood MOG-IgG was positive,the brain and spinal cord MRI showed multiple abnormal signals in white matter,optic nerve and spinal cord were normal. After treatment with methylprednisolone,visual acuity was restored,azathioprine and prednisone were taken orally after discharge,and prednisone gradually stopped after 6 months.Until recent follow-up,no recurrence of the disease,the blood MOG-IgG was positive,and the MRI of head and optic nerve was normal.Conclusions MOG antibody positive NMOSD can start with encephalitis,alternating left and right visual impairment,blood and CSF AQP4-IgG negative,MOG-IgG positive,brain MRI showed different stages of brain parenchymal damage in different parts. Treatment with methylprednisolone is effective and azathioprine can reduce relapse.关键词
髓鞘少突胶质细胞糖蛋白抗体/脑炎/视神经脊髓炎谱系/甲基泼尼松龙/硫唑嘌呤Key words
myelin oligodendrocyte glycoprotein antibody/encephalitis/neuromyelitis lineage/methylprednisolone/azathioprine分类
医药卫生
