多次复发MOG合并NMDAR叠加综合征1例 报道

A Case Report of Multiple Relapses of MOG Combined with NMDAR Superimposed Syndrome

摘要: 本文报道了1例儿童髓鞘少突胶质细胞糖蛋白(myelin oligodendrocyte glycoprotein, MOG)抗体相关疾病合并N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor, NMDAR)抗体双阳性患儿的急性期诊治及随访。文献回顾示MOG抗体相关疾病在儿童(小于9岁)中以脑部综合征为主，随着年龄增长(9~18岁)则多表现为视神经炎、脊髓炎。MOG抗体合并NMDAR抗体叠加综合征则既有MOG抗体相关疾病的脑病表现，也有NMDAR脑炎的表现。目前MOG抗体相关疾病治疗尚无充足的循证医学证据，在临床上常分为急性期和缓解期治疗。本文对1例MOG合并NMDAR叠加综合征的诊治、复发治疗及随访进行描述，为该病种研究提供临床依据。

Abstract: This article reports the acute-phase diagnosis and treatment as well as follow-up of a child with dual positivity for myelin oligodendrocyte glycoprotein (MOG) antibody and N-methyl-D-aspartate receptor (NMDAR) antibody. A literature review shows that MOG antibody-related diseases in children under 9 years old are mainly characterized by brain syndromes, while in older children (9~18 years old), they often present as optic neuritis or myelitis. The MOG antibody combined with NMDAR antibody superimposed syndrome exhibits both the encephalopathy manifestations of MOG antibody-related diseases and the symptoms of NMDAR encephalitis. Currently, there is insufficient evidence-based medical evidence for the treatment of MOG antibody-related diseases, and in clinical practice, it is often divided into acute-phase and remission-phase treatments. This article describes the diagnosis and treatment, recurrence treatment, and follow-up of a case of MOG combined with NMDAR superimposed syndrome, providing clinical evidence for the study of this disease.