Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Presenting as Intracranial Hypertension: A Case Report.

Jaydip Ray Chaudhuri, Jui Jade Bagul, Alluri Swathi, Bhim Sen Singhal, N Chakradhar Reddy, Kiran Kumar Vallam
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引用次数: 2

Abstract

The production of autoantibodies against myelin oligodendrocyte glycoprotein (MOG) can cause a spectrum of autoimmune disorders, including optic neuritis, transverse myelitis, brainstem encephalitis, and acute disseminated encephalomyelitis. In this study, we present the case of a 19-year-old woman with an unusual clinical presentation of intracranial hypertension (IH) and bilateral papilledema. The patient presented with symptoms of increased intracranial pressure, which followed a relapsing, remitting course over several months. Serial CSF studies showed an increased opening pressure during clinical relapses. The CSF and serum tested positive for MOG immunoglobulin G antibodies. Contrast-enhanced MRI of the brain showed mild meningeal enhancement in the left parietal region with subtle underlying cortical hyperintensities, indicating possible fluid-attenuated inversion recovery variable unilateral enhancement of the leptomeninges. The patient responded well to immunosuppressive therapy using rituximab. The presentation of MOG antibody-associated disease (MOGAD) as IH without optic neuritis is rare. This report presents the first description of a relapsing remitting course presenting each time with only symptoms of raised intracranial pressure, without developing any typical clinical manifestations of MOGAD.

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髓鞘少突胶质细胞糖蛋白抗体相关疾病表现为颅内高血压1例
髓鞘少突胶质细胞糖蛋白(MOG)自身抗体的产生可引起一系列自身免疫性疾病,包括视神经炎、横断脊髓炎、脑干脑炎和急性播散性脑脊髓炎。在这项研究中,我们提出的情况下,一个19岁的女性颅内高压(IH)和双侧乳头水肿的不寻常的临床表现。患者出现颅内压升高的症状,随后几个月复发,缓解。一系列脑脊液研究显示临床复发时开口压力增加。脑脊液和血清检测MOG免疫球蛋白G抗体阳性。脑MRI增强显示左顶叶轻度脑膜增强,伴有轻微的皮层下高信号,提示可能是单侧轻脑膜液体衰减反转恢复可变增强。患者对使用利妥昔单抗的免疫抑制治疗反应良好。MOG抗体相关疾病(MOGAD)表现为无视神经炎的IH是罕见的。本报告首次描述了一个复发缓解过程,每次只出现颅内压升高的症状,没有出现MOGAD的任何典型临床表现。
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