PMID- 33716942
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210316
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 12
DP  - 2021
TI  - Case Report: Anti-NMDAR Encephalitis With Anti-MOG CNS Demyelination After 
      Recurrent CNS Demyelination.
PG  - 639265
LID - 10.3389/fneur.2021.639265 [doi]
LID - 639265
AB  - Introduction: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis, a serious 
      neurological autoimmune disorder caused by autoantibodies with diverse clinical 
      manifestations, may simultaneously onset with antimyelin oligodendrocyte 
      glycoprotein (MOG) demyelination after recurrent central nervous system (CNS) 
      demyelination. Case Report: We present a case of anti-NMDAR encephalitis 
      combining with anti-MOG CNS demyelination following recurrent CNS demyelination. 
      A 38-year-old man admitted to hospital developed epileptic seizures following 
      recurrent episodes of cross-sensory disturbance and dizziness. Magnetic resonance 
      imaging (MRI) showed a demyelinating lesion in the right brainstem initially. 
      Despite a good response to methylprednisolone pulse therapy at the beginning, the 
      patient still had relapses and progression after corticosteroid reduction or 
      withdrawal. Then brain MRI discovered new serpentine lesions involving extensive 
      cerebral cortex on his second relapse. Repeat autoantibodies test indicated 
      cerebrospinal fluid (CSF) NMDAR antibodies coexisted with MOG-Abs simultaneously, 
      suggesting the diagnosis of anti-NMDAR encephalitis with anti-MOG CNS 
      demyelination. Results: After a definite diagnosis, the patient was treated with 
      mycophenolate mofetil (MMF) and corticosteroid. He was discharged after his 
      symptoms ameliorated. No neurological sequels remained, and there were no effects 
      on his activities of daily living after 6 months of immunoregulatory therapy of 
      MMF and corticosteroid. Conclusion: For individuals with recurrent CNS 
      demyelination, especially combining with cortical encephalitis, repeated 
      detection of autoantibodies against AE, and demyelination in CSF/serum can be 
      helpful to enable a definite early diagnosis. For patients who suffer from 
      anti-NMDAR encephalitis combining with anti-MOG CNS demyelination, second-line 
      immunotherapy is recommended when first-line treatment such as steroids, 
      intravenous immunoglobulin G (IVIG) and plasma exchange has been proven 
      ineffective to prevent the relapse of disease.
CI  - Copyright (c) 2021 Ren, Guo, Han, Wang and Li.
FAU - Ren, Bing-Yan
AU  - Ren BY
AD  - Department of Emergency, Nantong First People's Hospital, The Second Affiliated 
      Hospital of Nantong University, Nantong, China.
FAU - Guo, Yi
AU  - Guo Y
AD  - Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical 
      College of Jinan University, The First Affiliated Hospital of Southern University 
      of Science and Technology, Shenzhen, China.
FAU - Han, Jing
AU  - Han J
AD  - Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical 
      College of Jinan University, The First Affiliated Hospital of Southern University 
      of Science and Technology, Shenzhen, China.
FAU - Wang, Qian
AU  - Wang Q
AD  - Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical 
      College of Jinan University, The First Affiliated Hospital of Southern University 
      of Science and Technology, Shenzhen, China.
FAU - Li, Zai-Wang
AU  - Li ZW
AD  - Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical 
      College of Jinan University, The First Affiliated Hospital of Southern University 
      of Science and Technology, Shenzhen, China.
LA  - eng
PT  - Case Reports
DEP - 20210224
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC7943444
OTO - NOTNLM
OT  - anti-MOG CNS demyelination
OT  - anti-NMDAR encephalitis
OT  - diagnosis
OT  - recurrent CNS demyelination
OT  - therapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/03/16 06:00
MHDA- 2021/03/16 06:01
PMCR- 2021/02/24
CRDT- 2021/03/15 06:57
PHST- 2020/12/08 00:00 [received]
PHST- 2021/01/19 00:00 [accepted]
PHST- 2021/03/15 06:57 [entrez]
PHST- 2021/03/16 06:00 [pubmed]
PHST- 2021/03/16 06:01 [medline]
PHST- 2021/02/24 00:00 [pmc-release]
AID - 10.3389/fneur.2021.639265 [doi]
PST - epublish
SO  - Front Neurol. 2021 Feb 24;12:639265. doi: 10.3389/fneur.2021.639265. eCollection 
      2021.