MOGAD:一种新型疾病

Z. H. Yasir, Tushar Kant Singh, Rakesh Sharma, Mukesh Kumar
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摘要

髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)是一种免疫介导的炎症性神经系统疾病,也是中枢神经系统(CNS)脱髓鞘疾病的新成员。在MOGAD中,针对MOG蛋白的特异性抗体(MOG IgG)会导致中枢神经系统原发性脱髓鞘,但星形胶质细胞明显不受影响。在儿童中最常见的表现是 ADEM,在成人中则是 ON。我们接诊了一例 20 岁的女性患者,她主诉视力减退、肌肉无力、行走时拉伤,过去曾有过两次类似病史。临床特征、实验室检查和神经影像学检查有助于诊断。虽然预后一般良好,但也可能出现严重的残留残疾。这就强调了及时发现脱髓鞘病因的重要性,并根据标准方案通过合理使用类固醇来及时治疗这种新型疾病,从而保证患者的总体健康。因此,本病例凸显了提高人们对 MOGAD 的临床-实验室-影像学特征的认识的必要性,同时也提示了对视神经炎的病因进行详细的多学科检查以改善预后的重要性。
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MOGAD: A novel disease
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an immune-mediated inflammatory neurological disease and a new addition to the demyelinating disorders of the central nervous system(CNS).In MOGAD, specific antibodies (MOG IgG) targeting MOG protein lead to primary demyelination in the CNS, but notably spare astrocytes. The most frequent presentation in children is ADEM and in adult ON. We present a case of 20 year old female who visited our OPD with complaints of diminution of vision with muscular weakness and strain while walking with a history of two similar episodes in the past. The clinical characteristics, laboratory investigation and neuroimaging help in diagnosis. Although the prognosis is generally favorable but severe residual disability can also occur.This underscores the importance of identifying the causes of demyelination on time and prompt treatment of this rather novel disease by judicious use of steroids based on standard protocolresulting in the general well-being of the patient. The present case therefore highlights the need to create awareness of the Clinical-Lab-Imaging characteristics of MOGAD andalso suggests the importance of making a detailed multidisciplinary approach into the cause of optic neuritis for better prognosis.
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