A child who suffered from HSV encephalitis and AE with positive anti-MOG results: a case report.

IF 1.5 4区医学 Q4 NEUROSCIENCES

Brain injury Pub Date : 2025-03-14 DOI:10.1080/02699052.2025.2478431

Xilong Chen, Shixia Yue, Bin Yan, Taining Zhang, Bingying Zhou, Weikai Wang

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引用次数: 0

Abstract

Objective: To investigate the clinical manifestations of a pediatric case involving herpes simplex virus (HSV) encephalitis concurrent with autoimmune encephalitis (AE), which is characterized by a positive anti-myelin oligodendrocyte glycoprotein (MOG) antibody status.

Results: A 12-year-old girl initially presented with symptoms of autoimmune encephalitis, including weakness and poor appetite, followed by headache, dizziness, and personality changes, which are indicative of disease progression. Cerebrospinal fluid routine biochemical tests demonstrated abnormal results. Cerebrospinal fluid mNGS results demonstrated human herpesvirus type I, and autoimmune encephalitis antibody tests suggested a positive result for anti-myelin oligodendrocyte glycoprotein (MOG) antibodies (1:100). Brain MRI revealed abnormal signals in the bilateral frontal lobes and dorsal thalamus. Therefore, diagnoses of herpes simplex virus encephalitis and autoimmune encephalitis were determined. After treatment with acyclovir, gamma globulin and hormones, the patient exhibited significant improvement in her symptoms.

Conclusions: Children with herpes simplex virus encephalitis combined with autoimmune encephalitis may present with atypical clinical symptoms, and a positive anti-MOG antibody test is rarely observed, with no previous reports on this occurrence. The early detection of the relevant pathogens (in addition to timely reevaluation) can aid in accurate diagnosis. Moreover, antiviral and immunosuppressive therapy may significantly improve symptoms and patient prognosis.

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目的：探讨1例单纯疱疹病毒（HSV）脑炎合并自身免疫性脑炎（AE）患儿抗髓鞘少突胶质细胞糖蛋白（MOG）抗体阳性的临床表现。结果：一名12岁女孩最初表现为自身免疫性脑炎症状，包括虚弱和食欲不振，随后出现头痛、头晕和人格改变，这些都表明疾病进展。脑脊液常规生化检查结果异常。脑脊液mNGS结果显示为人类疱疹病毒I型，自身免疫性脑炎抗体测试显示抗髓鞘少突胶质细胞糖蛋白（MOG）抗体阳性（1:100）。脑MRI显示双侧额叶和丘脑背侧有异常信号。因此，单纯疱疹病毒性脑炎和自身免疫性脑炎的诊断被确定。在给予阿昔洛韦、丙种球蛋白和激素治疗后，患者的症状明显改善。结论：单纯疱疹病毒性脑炎合并自身免疫性脑炎患儿可能表现为非典型临床症状，抗mog抗体检测阳性的病例较少，既往未见相关报道。早期发现相关病原体（除了及时重新评估外）有助于准确诊断。此外，抗病毒和免疫抑制治疗可显著改善症状和患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain injury 医学-康复医学

CiteScore

3.50

自引率

5.30%

发文量

148

审稿时长

12 months

期刊介绍： Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.