PDF(Pubmed)
Abstract：
Anti-myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) associated disorder (MOGAD) is an immune-mediated central nervous system (CNS) inflammatory demyelinating disorder that has been widely recognized in recent years. It is distinct from multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which are separate disease spectrums. Here we report the case of a 5-year-old boy who was admitted for 3 days with fever, headache, and vomiting. Magnetic resonance imaging revealed abnormal hyperintensity in the left thalamus and positive serum IgM for M. pneumoniae. After treatment with azithromycin, the headache gradually disappeared, but paralysis and urinary retention occurred on the 6th day after admission. MRI re-examination showed that the original abnormal signal in the left thalamus was significantly weakened, but new abnormal signals appeared in the brain and cerebrospinal cord, and the serum MOG-IgG was positive. After treatment, the child has fully recovered and is still receiving follow-up care. We believe that this is a case of MOGAD in a child with a biphasic ADEM phenotype secondary to M. pneumoniae infection, which has potential value in elucidating the pathophysiology of MOGAD.
摘要：
抗髓磷脂少突胶质细胞糖蛋白（MOG）-免疫球蛋白G（IgG）相关疾病（MOGAD）是一种免疫介导的中枢神经系统（CNS）炎性脱髓鞘疾病，近年来已被广泛认可。它不同于多发性硬化症（MS）和视神经脊髓炎谱系障碍（NMOSD），它们是独立的疾病谱。在这里，我们报道了一个5岁男孩因发烧入院3天的案例，头痛,和呕吐。磁共振成像显示左丘脑异常高强度和肺炎支原体血清IgM阳性。阿奇霉素治疗后，头痛逐渐消失,但在入院后第6天出现瘫痪和尿潴留。MRI复检显示左丘脑原始异常信号明显减弱,但是大脑和脑脊髓出现了新的异常信号，血清MOG-IgG阳性。治疗后,孩子已经完全康复，仍在接受后续护理。我们认为，这是一例MOGAD的儿童，具有继发于肺炎支原体感染的双相ADEM表型，这对阐明MOGAD的病理生理学具有潜在价值。
