Faremos uma breve revisão das características epidemiológicas, manifestações clínicas, considerações diagnósticas e opções de tratamento da neurite óptica associada à glicoproteína de oligodendrócito de mielina-IgG. O espectro clínico desta doença desmielinizante inflamatória recém-reconhecida está se expandindo rapidamente. O diagnóstico pode ser feito com base na presença de um anticorpo específico, geralmente sorológico contra glicoproteína de oligodendrócito de mielina (IgG, ensaio baseado em células), e presença de evento desmielinizante (neurite óptica, mielite, síndrome do tronco cerebral, lesões corticais com convulsões). A esclerose múltipla representa outro importante diagnóstico diferencial de glicoproteína de oligodendrócito de mielina-IgG. No entanto, em contraste com neuromyelitis optica spectrum disorder associada com presença de anticorpo contra aquaporina 4, a recuperação visual tende a ser mais favorável e responde bem ao tratamento com corticoide em altas doses. Tipicamente os pacientes apresentam neurite óptica recorrente, muitas vezes bilateral, com perda de visão frequentemente severa e alta prevalência de edema do disco óptico na fase aguda.

Myelin oligodendrocyte glycoprotein Multiple sclerosis Neuromyelitis optica Optic neuritisĪ neurite óptica associada à glicoproteína de oligodendrócito de mielina-IgG foi estabelecida como uma nova entidade de neuropatia óptica imunomediada. We briefly review the epidemiological characteristics, clinical manifestations, diagnostic considerations, and treatment options of myelin oligodendrocyte glycoprotein-IgG-associated optic neuritis. The clinical spectrum of this newly recognized inflammatory demyelinating disease is expanding rapidly. The diagnosis can be made on the basis of the presence of a specific, usually serological, antibody against myelin oligodendrocyte glycoprotein (IgG cell-based assay), and a demyelinating event (optic neuritis, myelitis, brainstem syndrome, or cortical lesions with seizures). Close monitoring for signs of relapse and long-term immunosuppression may be considered to maintain optimal visual function. Another important differential diagnosis of myelin oligodendrocyte glycoprotein-IgG-associated optic neuritis is multiple sclerosis. However, in contrast to aquaporin 4-IgG-seropositive neuromyelitis optica spectrum disorder, visual recovery tends to be more favorable, with good response to steroid treatment. Patients usually present with recurrent optic neuritis, often bilaterally with initially severe vision loss and optic disc edema.

All rights reserved.Myelin oligodendrocyte glycoprotein-immunoglobulin G (IgG)-associated optic neuritis has been established as a new entity of immune-mediated optic neuropathy. This case demonstrates that patients presenting with symptoms concerning for NMOSD who are AQP4-Ab-negative should be tested for anti-MOG antibodies for optimized disease management and important prognostic implications.Īquaporin-4 Myelin-oligodendrocyte glycoprotein Neuromyelitis optica Neuromyelitis optica spectrum disorders Optic neuritis.Ĭopyright © 2019 Elsevier B.V. CSF studies showed negative anti-AQP4 antibodies and positive anti-MOG antibodies. After successful treatment on a steroid regimen, this patient represented two weeks following discharge with seizure and was found to have unilateral meningeal T2-FLAIR MRI hyperintensity with associated cortical swelling, a rare finding. We describe the case of a patient who initially presented with 10-day history of right-sided retro-orbital headache worse with lateral gaze, photophobia, and subjective decreased visual acuity. These patients present with distinct clinical demyelinating syndrome often confused for multiple sclerosis. A subset of patients with neuromyelitis optica spectrum disorders are positive for myelin-oligodendrocyte glycoprotein (MOG) antibodies.

Optic neuritis anti mog