Anti-MOG encephalitis mimicking small vessel CNS vasculitis

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 determin...

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Autores: Patterson, Kristina, Iglesias, Estibaliz, Nasrallah, Maclean, González-Álvarez, Verónica, Suñol, Mariona, Anton, Jordi, Saiz Hinarejos, Albert, Lancaster, Eric, Armangué, Thaís
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/164792
Acesso em linha:https://hdl.handle.net/2445/164792
Access Level:acceso abierto
Palavra-chave:Encefalitis
Símptomes
Biòpsia
Immunoglobulines
Encephalitis
Symptoms
Biopsy
Immunoglobulins
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spelling Anti-MOG encephalitis mimicking small vessel CNS vasculitisPatterson, KristinaIglesias, EstibalizNasrallah, MacleanGonzález-Álvarez, VerónicaSuñol, MarionaAnton, JordiSaiz Hinarejos, AlbertLancaster, EricArmangué, ThaísEncefalitisSímptomesBiòpsiaImmunoglobulinesEncephalitisSymptomsBiopsyImmunoglobulinsObjective: 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.American Academy of Neurology2020202020192020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion7 p.application/pdfhttps://hdl.handle.net/2445/164792Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1212/NXI.0000000000000538Neurology. Neuroimmunology & Neuroinflammation, 2019, vol. 6, num. 2, p. 538https://doi.org/10.1212/NXI.0000000000000538cc-by-nc-nd (c) Patterson, Kristina et al., 2019http://creativecommons.org/licenses/by-nc-nd/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1647922026-05-29T05:05:01Z
dc.title.none.fl_str_mv Anti-MOG encephalitis mimicking small vessel CNS vasculitis
title Anti-MOG encephalitis mimicking small vessel CNS vasculitis
spellingShingle Anti-MOG encephalitis mimicking small vessel CNS vasculitis
Patterson, Kristina
Encefalitis
Símptomes
Biòpsia
Immunoglobulines
Encephalitis
Symptoms
Biopsy
Immunoglobulins
title_short Anti-MOG encephalitis mimicking small vessel CNS vasculitis
title_full Anti-MOG encephalitis mimicking small vessel CNS vasculitis
title_fullStr Anti-MOG encephalitis mimicking small vessel CNS vasculitis
title_full_unstemmed Anti-MOG encephalitis mimicking small vessel CNS vasculitis
title_sort Anti-MOG encephalitis mimicking small vessel CNS vasculitis
dc.creator.none.fl_str_mv Patterson, Kristina
Iglesias, Estibaliz
Nasrallah, Maclean
González-Álvarez, Verónica
Suñol, Mariona
Anton, Jordi
Saiz Hinarejos, Albert
Lancaster, Eric
Armangué, Thaís
author Patterson, Kristina
author_facet Patterson, Kristina
Iglesias, Estibaliz
Nasrallah, Maclean
González-Álvarez, Verónica
Suñol, Mariona
Anton, Jordi
Saiz Hinarejos, Albert
Lancaster, Eric
Armangué, Thaís
author_role author
author2 Iglesias, Estibaliz
Nasrallah, Maclean
González-Álvarez, Verónica
Suñol, Mariona
Anton, Jordi
Saiz Hinarejos, Albert
Lancaster, Eric
Armangué, Thaís
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Encefalitis
Símptomes
Biòpsia
Immunoglobulines
Encephalitis
Symptoms
Biopsy
Immunoglobulins
topic Encefalitis
Símptomes
Biòpsia
Immunoglobulines
Encephalitis
Symptoms
Biopsy
Immunoglobulins
description 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.
publishDate 2019
dc.date.none.fl_str_mv 2019
2020
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/164792
url https://hdl.handle.net/2445/164792
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1212/NXI.0000000000000538
Neurology. Neuroimmunology & Neuroinflammation, 2019, vol. 6, num. 2, p. 538
https://doi.org/10.1212/NXI.0000000000000538
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Patterson, Kristina et al., 2019
http://creativecommons.org/licenses/by-nc-nd/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Patterson, Kristina et al., 2019
http://creativecommons.org/licenses/by-nc-nd/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 7 p.
application/pdf
dc.publisher.none.fl_str_mv American Academy of Neurology
publisher.none.fl_str_mv American Academy of Neurology
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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