Myelin-oligodendrocyte glycoprotein antibodies in adults with a neuromyelitis optica phenotype
Myelin-oligodendrocyte glycoprotein antibodies in adults with a neuromyelitis optica phenotype
复制标题
DOI：
10.1212/wnl.0b013e31826aac4e
复制
发表时间：
2012-09-01
期刊：
影响因子：
9.9
通讯作者：
Vincent, Angela
中科院分区：
文献类型：
--
作者：
Kitley, Joanna;Woodhall, Mark;Vincent, Angela
目的：报道髓鞘-少突胶质细胞糖蛋白（MOG）抗体与成人水通道蛋白-4 （AQP4）抗体血清阴性视神经脊髓炎（NMO）和视神经脊髓炎频谱障碍（NMOSD）的关系。方法：我们描述了4例具有MOG抗体的NMO/NMOSD型成年患者的临床和血清学特征。结果：27例成人aqp4血清阴性NMO/NMOSD患者检测MOG抗体。4例（男3例，女1例）严重视神经炎和/或纵向广泛的横贯脊髓炎阳性。4例患者均经类固醇或血浆置换后恢复良好。2例患者在迅速停用皮质类固醇后出现症状复发，但在平均12个月的随访中没有出现进一步复发，尽管有3例患者仍在接受治疗。临床恢复后影像学异常完全消失，4例患者MOG抗体滴度均下降。44例AQP4抗体阳性的NMO/NMOSD患者、75例成年多发性硬化症患者和47例健康人均未发现MOG抗体。结论：MOG抗体相关的NMO/NMOSD可以解释一些以前被认为是aqp4血清阴性的NMO/NMOSD病例。我们的4例患者似乎比那些典型的AQP4抗体介导的疾病有更有利的临床结果。然而，需要进一步研究NMO/NMOSD和其他脱髓鞘疾病，以帮助阐明MOG抗体的诊断和预后相关性。神经病学(R) 2012；79:1273 - 1277
Objectives: To report an association of myelin-oligodendrocyte glycoprotein (MOG) antibodies with aquaporin-4 (AQP4) antibody-seronegative neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) in adults.Methods: We describe the clinical and serologic features of 4 adult patients with an NMO/NMOSD phenotype who had antibodies to MOG.Results: Twenty-seven adult AQP4-seronegative NMO/NMOSD patients were tested for MOG antibodies. Four patients (3 male, 1 female) with severe optic neuritis and/or longitudinally extensive transverse myelitis were positive. All 4 made good recoveries with steroids or plasma exchange. Two patients experienced recurrence of symptoms when corticosteroids were withdrawn quickly but none have experienced further relapses over a mean follow-up of 12 months, although 3 patients remain on treatment. Imaging abnormalities resolved fully following clinical recovery and MOG antibody titers fell in all 4 patients. MOG antibodies were not found in 44 AQP4 antibody-positive NMO/NMOSD patients, 75 adult patients with multiple sclerosis, or 47 healthy individuals.Conclusions: MOG antibody-associated NMO/NMOSD could account for some cases thought previously to be AQP4-seronegative NMO/NMOSD. Our 4 patients appear to have more favorable clinical outcomes than those with typical AQP4 antibody-mediated disease. However, further studies of NMO/NMOSD and other demyelinating conditions are required to help clarify the diagnostic and prognostic relevance of MOG antibodies. Neurology (R) 2012;79:1273-1277