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Title: Anti-MOG encephalitis mimicking small vessel CNS vasculitis
Author: Patterson, Kristina
Iglesias, Estibaliz
Nasrallah, Maclean
González-Álvarez, Verónica
Suñol, Mariona
Anton, Jordi
Saiz Hinarejos, Albert
Lancaster, Eric
Armangué, Thaís
Keywords: Encefalitis
Issue Date: 1-Feb-2019
Publisher: American Academy of Neurology
Abstract: Objective: To report 2 patients with anti-myelin oligodendrocyte glycoprotein (MOG)-associated encephalitis who were initially misdiagnosed with small vessel primary CNS vasculitis. Methods: Review of symptoms, MRI and neuropathologic features, and response to treatment. MOG antibodies were determined in serum and CSF using a cell-based assay. Results: Symptoms included fever, headache, and progressive mental status changes and focal neurologic deficits. CSF studies revealed lymphocytic pleocytosis, and both patients had abnormal brain MRIs. Brain biopsy samples showed prominent lymphocytic infiltration of the wall of small vessels; these findings initially suggested small vessel CNS vasculitis, and both patients were treated accordingly. Although 1 patient had a relapsing-remitting course not responsive to cyclophosphamide, the other one (also treated with cyclophosphamide) did not relapse. Retrospective assessment of serum and CSF demonstrated MOG antibodies in both cases, and review of biopsy specimens showed absence of fibrinoid necrosis (a pathologic requirement for small vessel CNS vasculitis). Conclusions: Anti-MOG-associated encephalitis can be mistaken for small vessel CNS vasculitis. This is important because the diagnosis of anti-MOG-associated encephalitis does not require brain biopsy and can be established with a serologic test.
Note: Reproducció del document publicat a:
It is part of: Neurology. Neuroimmunology & Neuroinflammation, 2019, vol. 6, num. 2, p. 538
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ISSN: 2332-7812
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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