Clinical Characteristics of Cases with Anti-N-methyl-D-aspartate Receptor Encephalitis and Myelin Oligodendrocyte Glycoprotein Antibody Associated Diseases
- VernacularTitle:抗N-甲基-D-天冬氨酸受体脑炎与髓鞘少突胶质细胞糖蛋白抗体相关疾病并存的临床特征
- Author:
Li-ping CAO
1
;
Xiao-yu MA
2
;
Yuan-hua WU
1
;
Jing-qi WANG
2
;
Ya-qing SHU
2
;
Xiao-bo SUN
2
;
Xiao-jing LI
3
;
Wei QIU
2
Author Information
1. The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China//The First Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang 550001, China
2. Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
3. Department of Neurology, Guangzhou Women and Children Medical Center, Guangzhou 510000, China
- Publication Type:Journal Article
- Keywords:
anti-NMDAR encephalitis;
MOG antibody related diseases;
analysis of clinical characteristics
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(6):858-866
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To investigate the clinical characteristics of Anti-N-methyl-D-aspartate receptor encephalitis coexisting with myelin oligodendroprotein antibody(MOG) . 【Methods】 Retrospective analysis was performed on 36 patients with anti-NMDAR encephalitis who were admitted to the Department of Neurology of the Third Affiliated Hospital of Sun Yat-sen University and the Department of Neurology of Guangzhou Women and Children Medical Center from February 2015 to August 2019. Among them, 17 patients were in the coexisting group with MOG antibody related diseases and 19 patients were in the control group with simple anti-NMDAR encephalitis. The first symptoms, imaging features, laboratory examination, treatment and prognosis of the two groups of patients were analyzed and summarized. 【Results】 Compared with the control group, there were more male than female patients in the coexisting group, so fewer of them were complicated with ovarian teratoma. In some patients, the first symptoms were atypical demyelination of anti-NMDAR encephalitis. The titer of cerebrospinal fluid anti-NMDAR antibody(1∶1 ~ 1∶100) and serum MOG antibody(1∶25 ~ 1∶1 280) fluctuated. The imaging findings showed not only cortical and subcortical involvement but also subcortical white matter involvement or spinal cord involvement. From the analysis of treatment and prognosis, the symptoms of patients in both groups were improved after immunotherapy. After 3-50 months of follow-up, 3 patients in the coexisting group and 1 patient in the control group had recurrence, and all of them responded well to immunotherapy again. 【Conclusions】 Clinically, the incidence of Anti-NMDAR encephalitis and MOG antibody related diseases mostly occur in male patients, with more adults than children. Combined tumor is rare, and the patients have a good response to immunotherapy. It is speculated that such patients have a relatively specific immune pathogenesis.
