A rare concurrence: Antibodies against Myelin Oligodendrocyte Glycoprotein and N-methyl-d-aspartate receptor in a child

Sarıgeçili, Esra; Cobanogullari, Meltem Direk; Kömür, Mustafa; Okuyaz, Çetin

doi:10.1016/j.msard.2018.12.017

Cited by 31 publications

(27 citation statements)

References 9 publications

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“…This is due to the fact that, according to them, NMDAR antibodies were not present when the patient showed typical AIE symptoms. However, Sarigecili et al (13) reported a case of co-occurrence of antibodies against both MOG and NMDAR in a child, and authors believed that multiple seropositivity may be more frequent than is reported. Four cases in our report had multiple clinical features of central nervous system autoimmune diseases in the first episode and the disease remission was adequate in response to immunosuppressive therapy, but patients subsequently developed severe visual impairments.…”

Section: Discussionmentioning

confidence: 98%

“…However, anti-MOG IDDS could also occur first, followed by anti-NMDAR encephalitis, and a certain type of pathogenic antibody may be critical in the course of disease. In addition, anti-NMDAR encephalitis and anti-MOG IDDs could also occur simultaneously (3, 12, 13). These findings suggest that, when a patient is diagnosed with either of these two diseases, the potential co-occurrence of the other disease should be considered by the medical practitioners.…”

Section: Discussionmentioning

confidence: 99%

“…The international consensus is now that, anti-MOG antibodies result in demyelinating diseases, of the neuromyelitis optical spectrum disorders (NMOSD) (7, 9, 10). The pathogenic mechanisms of these two diseases were once believed to be entirely different, but several cases have recently reported the coexistence of anti-NMDAR and anti-MOG antibodies (3, 11–13). However, these consisted of individual cases or small sample reports, and no systematic review of large-scale samples has summarized, to date, the characteristic features of the coexistence of anti-NDMAR encephalitis and anti-MOG IDDs.…”

Section: Introductionmentioning

confidence: 99%

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Co-occurrence of Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Anti-myelin Oligodendrocyte Glycoprotein Inflammatory Demyelinating Diseases: A Clinical Phenomenon to Be Taken Seriously

Ren

Chen

et al. 2019

Front. Neurol.

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Background: Anti-N-methyl-D-aspartate receptor (NMDAR) immunoglobulin G antibodies which exist on myelin sheaths, composed of oligodendrocytes, especially target GluN1 subunits and are highly characteristic of anti-NMDAR encephalitis which is a newly recognized autoimmune encephalitis (AE) characterized by psychiatric symptoms, behavioral abnormalities, seizures, cognitive impairment and other clinical symptoms. Myelin oligodendrocyte glycoprotein (MOG) is a type of protein which is expressed on the surface of oligodendrocytes and myelin in the central nervous system. Anti-MOG antibodies cause demyelination. In some rare reported cases, these two types of antibodies have been found to co-exist, but the underlying mechanisms remain unknown.Case presentation: Here we report cases of 4 inpatients (median age 31.5 years, age range 27–43 years) from The Second Xiangya Hospital of Central South University between March 2018 and April 2019. Two of the cases were first diagnosed as anti-NMDAR encephalitis and had developed visual impairments in the course of the dosage reduction during corticosteroid therapy. They were found at the time, to have anti-MOG antibody-positive CSF and/or serum. Another patient was diagnosed with anti-MOG inflammatory demyelinating diseases (IDDs) when he tested double positive for both anti-NMDAR and anti-MOG antibodies early in the course of his illness. Over the course of the dosage reduction during corticosteroid therapy, his symptoms deteriorated; however, anti-MOG antibody levels elevated while anti-NDMAR antibody levels remained low. The other patient had initially developed psychiatric symptoms and limb weakness. She was also double positive for anti-NMDAR and anti-MOG antibodies early in the course of her illness. However, over the course of the dosage reduction during corticosteroid therapy, her symptoms worsened and levels of both antibodies elevated.Conclusion: Anti-NMDAR and anti-MOG antibodies may coexist in rare cases. In addition, anti-NMDAR encephalitis and anti-MOG inflammatory demyelinating diseases may occur either simultaneously or in succession. Thus, when a patient is diagnosed with either of these two diseases, but exhibits symptoms of the other disease, the possibility of co-occurrence with both these diseases should be considered and the appropriate antibodies should be accurately detected to enable prompt selection of appropriate treatments by the physicians.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Co-occurrence of Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Anti-myelin Oligodendrocyte Glycoprotein Inflammatory Demyelinating Diseases: A Clinical Phenomenon to Be Taken Seriously

Ren

Chen

et al. 2019

Front. Neurol.

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“…After this study, there have been some cases of NMDAR antibody encephalitis combined with MOG antibody-related demyelinating disease that are reported. Clinical phenotypes with optic neuritis are relatively common in adults and older children, and others include optic neuromyelitis spectrum disorders and encephalitis [10][11][12][13] . Recurrent demyelinating episodes occurred in certain patients that require second-line immunotherapy and may leave neurological sequelae, and the most common one is visual impairment [8][9][10][11][12] .…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of anti-NMDAR encephalitis combined with MOG antibody in children

Hou¹,

Tian

et al. 2020

Multiple Sclerosis and Related Disorders

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“…According to the results from a systematic review of literature provided in a recent article [11], a MOG antibody-associated demyelination demyelination (MOGAD) and anti-NMDARencephalitis were only reported in less than 20 adult and pediatric patients [3,[11], [12], [13], [14]]; only a few of them had acute seizures. In contrast to our patient, the majority of patients described in the literature had their demyelinating episode and encephalitis in close temporal proximity.…”

Section: Discussionmentioning

confidence: 99%

Overlapping demyelinating syndrome and anti-N-methyl-d-aspartate receptor encephalitis with seizures

Taraschenko

Zabad

2019

Epilepsy & Behavior Reports

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Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, the most recognized type of autoimmune encephalitis, manifests with rapid cognitive decline, psychosis, and seizures that develop in 78–86% of patients. Recently, anti-NMDAR encephalitis was reported in association with demyelinating diseases which are accompanied by a characteristic clinical phenotype, imaging abnormalities, and the presence of antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) in bodily fluids. The patient presented herein suffered from bilateral optic neuritis followed by recurrent encephalitis with focal seizures and demonstrated anti-NMDAR and MOG-IgGs in the cerebrospinal fluid and serum, respectively. Her symptoms responded to immunotherapy and antiseizure medication. The recognition of the novel syndrome of MOG antibody-associated demyelination (MOGAD), encompassing the overlapping anti-NMDAR encephalitis and other MOG-IgG associated disorders, is important for the successful management of these patients.

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A rare concurrence: Antibodies against Myelin Oligodendrocyte Glycoprotein and N-methyl-d-aspartate receptor in a child

Cited by 31 publications

References 9 publications

Co-occurrence of Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Anti-myelin Oligodendrocyte Glycoprotein Inflammatory Demyelinating Diseases: A Clinical Phenomenon to Be Taken Seriously

Co-occurrence of Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Anti-myelin Oligodendrocyte Glycoprotein Inflammatory Demyelinating Diseases: A Clinical Phenomenon to Be Taken Seriously

Clinical analysis of anti-NMDAR encephalitis combined with MOG antibody in children

Overlapping demyelinating syndrome and anti-N-methyl-d-aspartate receptor encephalitis with seizures

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