Comorbid myelin oligodendrocyte glycoprotein antibody disease misdiagnosed as relapse of schizophrenia: a case report and literature review
10.3760/cma.j.cn113661-20220907-00255
- VernacularTitle:共病髓鞘少突胶质细胞糖蛋白抗体病误诊为精神分裂症复发1例
- Author:
Yangbo CHEN
1
;
Na LI
1
;
Kai ZHANG
1
;
Ting XIE
1
Author Information
1. 浙江省立同德医院精神老年重症医学科，杭州311122
- Publication Type:Journal Article
- Keywords:
Schizophrenia;
Myelin-oligodendrocyte glycoprotein;
Idiopathic inflammatory demyelinating disease;
Malignant syndrome;
Diagnostic errors
- From:
Chinese Journal of Psychiatry
2023;56(3):221-226
- CountryChina
- Language:Chinese
-
Abstract:
Idiopathic Inflammatory Demyelinating Diseases (IIDDs) mediated by Myelin oligodendrocyte glycoprotein (MOG) antibodies, also known as MOG antibody diseases. The clinical manifestations of MOG antibody disease are diverse, but the onset of mental symptoms has been rarely reported. This case is a 42-year-old female patient with schizophrenia who was diagnosed with an onset of mental symptoms. Clinicians in the patient′s local hospital diagnosed her as a recurrence of schizophrenia, and unconventional adjustment of psychotropic drugs led to the occurrence of malignant syndrome, exacerbating the patient′s condition, and causing additional damage such as shock and multiple organ failure. The patient showed significant behavioral and mental abnormalities, left eyelid ptosis, decreased left eye vision, blurred vision, unstable walking, grade Ⅲ left limb muscle strength, hypertonia, and weakened tendon reflex. Brain MRI showed abnormal signals in the brainstem, bilateral thalamus, and bilateral frontal sulcus, with positive test results of MOG antibodies. Based on the clinical characteristics of the patient and the diagnostic criteria for MOG antibody disease, the patient was diagnosed as MOG antibody disease. Patient′s symptoms showed improvement after treatment with hormones, gamma globulin stimulation, and neurotrophic agent. This article reviews the clinical data of patient and reviews relevant literature, aiming to explore the clinical manifestations of MOG antibody disease, help health professionals to increase vigilance, and prevent missed diagnosis and misdiagnosis of this disease.
