Anti-NMDA receptor encephalitis and MOG-associated demyelination - a case report with long-term follow-up and a systematic review.

Autor: Berek K; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria., Grams A; Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria., Uprimny C; Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria., Prieschl M; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria., Ramberger M; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria., Unterberger I; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria., Deisenhammer F; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria., Reindl M; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria., Hegen H; Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria. harald.hegen@i-med.ac.at.
Jazyk: angličtina
Zdroj: BMC neurology [BMC Neurol] 2022 Nov 16; Vol. 22 (1), pp. 434. Date of Electronic Publication: 2022 Nov 16.
DOI: 10.1186/s12883-022-02974-x
Abstrakt: Background: Overlap syndromes of anti-NMDA receptor encephalitis and MOG-mediated demyelination have been reported. In this case we provide a long-term longitudinal follow-up of clinical and imaging characteristics as well as of antibody dynamics.
Case Presentation: We report a 32-year-old male patient who presented with psychosis, decreased consciousness and movement disorders and was tested positive for anti-NMDA receptor antibodies. Forty-four months after symptom onset and diagnosis of autoimmune encephalitis, he suffered from relapse. At this time, the patient developed anti-MOG and anti-Caspr2 antibodies. Treatment with plasmapheresis, steroids and rituximab eventually led to substantial clinical and radiological improvement. Anti-Caspr2 antibodies persisted, anti-NMDA receptor antibodies decreased, while anti-MOG antibodies turned negative again.
Conclusion: We provide long-term longitudinal follow-up of a patient with anti-NMDA receptor encephalitis who developed triple antibody positivity at the time of relapse. Antibody dynamics were associated with clinical disease course.
(© 2022. The Author(s).)
Databáze: MEDLINE
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