Clinical analysis of a patient simultaneously positive for antibodies of myelin oligodendrocyte glycoprotein and anti-N-methyl-D-aspartate receptor: A case report.

Abstract

RATIONALE:

Myelin oligodendrocyte glycoprotein (MOG) antibody (MOG-Ab) disease (MOG-AD) is a type of demyelinating disease of the central nervous system characterized by a high frequency of optic neuritis (ON) attacks. anti-Nmethyl-D-aspartate receptor (NMDAR) encephalitis (anti-NMDARe) is an autoimmune disorder characterized by memory deficits, conscious disturbance, and seizures. Cases of simultaneous occurrence of MOG-Ab and anti-NMDARe antibody (anti-NMDARe-Ab) are rarely reported and could be mistaken for overlapping MOG-antibody disease (MOG-AD) and NMDARe. The diagnosis of such patients is challenging.

PATIENT CONCERNS:

We report the case of a 37-year-old man who presented with recurrent headaches for 3 months and worsening symptoms over 2 weeks. He had a history of ON. He had a generalized seizure after 7 days in the hospital.

DIAGNOSIS:

Brain magnetic resonance imaging (MRI) and cerebrospinal fluid tests showed no apparent abnormalities. Repeat MRI showed slight lesions 7 days later, and cerebrospinal fluid tests showed the simultaneous occurrence of MOG-Ab and anti-NMDARe-Ab.

INTERVENTIONS:

He completely recovered after treatment with low doses of oral corticosteroids.

OUTCOMES:

Two months and 2 years follow-up showed that his condition was stable.

LESSONS:

The co-occurrence of MOG-Ab and anti-NMDAR-Ab does not indicate the co-occurrence of MOG-AD and anti-NMDARe. Laboratory findings should be combined with the clinical features to achieve an accurate and suitable diagnosis.

• Authors: Liming Cao, Lijie Ren, Xuming Huang
• Journal: Medicine (Medicine (Baltimore)) Vol. 100 Issue 1 Pg. e24234 (Jan 08 2021) ISSN: 1536-5964 [Electronic] United States
• PMID: 33429822 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Myelin-Oligodendrocyte Glycoprotein
• Receptors, N-Methyl-D-Aspartate

Topics

• Adult
• Anti-N-Methyl-D-Aspartate Receptor Encephalitis (cerebrospinal fluid, complications, diagnosis, diagnostic imaging)
• Demyelinating Autoimmune Diseases, CNS (cerebrospinal fluid, complications, diagnosis, diagnostic imaging)
• Diagnosis, Differential
• Headache (etiology)
• Humans
• Magnetic Resonance Imaging
• Male
• Myelin-Oligodendrocyte Glycoprotein (immunology)
• Optic Neuritis (etiology)
• Receptors, N-Methyl-D-Aspartate (immunology)
• Seizures (etiology)