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01-03-2021 | Anti-NMDA Receptor Encephalitis | Review Article

Clinical features and management of coexisting anti-N-methyl-D-aspartate receptor encephalitis and myelin oligodendrocyte glycoprotein antibody–associated encephalomyelitis: a case report and review of the literature

Authors: Di Nan, Ying Zhang, Jinming Han, Tao Jin

Published in: Neurological Sciences | Issue 3/2021

Abstract

Background

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune encephalitis caused by antibodies targeting the GluN1 subunit of NMDA receptors. Myelin oligodendrocyte glycoprotein (MOG) antibody disorders are now widely accepted as peculiar neuroimmunological diseases with specific clinical and pathological features. Some rare cases of overlapping anti-NMDA receptor encephalitis and MOG antibody–associated diseases have been reported, presenting complex clinical symptoms that make the disease more difficult to recognize.

Method

In accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the terms “NMDAR” and “MOG,” “NMDAR” and “demyelination,” and “MOG” and “encephalitis” were searched in PubMed. Clinical cases with dual-positive anti-NMDA cerebrospinal fluid receptors and MOG serum antibodies during the disease course were included in this study.

Results

A total of 25 patients were analyzed in this study. The age at onset ranged from 3 to 54 years. The median number of relapses was 2.8. Administration of intravenous methylprednisolone and immunoglobulin was the most widely used treatment strategy (19/25 patients). Second-line treatments such as administration of mycophenolate mofetil, rituximab, interferon-β, azathioprine, cyclophosphamide, and temozolomide were also reported, followed by good outcomes.

Conclusions

The rates of coexisting anti-NMDA receptor encephalitis and MOG antibody–associated encephalomyelitis may be underestimated. Clinical symptoms such as seizures and cognitive decline accompanied by atypical central nervous system demyelination serve as warning signs of possible coexisting anti-NMDA receptor encephalitis and MOG antibody–associated encephalomyelitis. These patients could achieve good outcomes under proper immunotherapies.

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Title: Clinical features and management of coexisting anti-N-methyl-D-aspartate receptor encephalitis and myelin oligodendrocyte glycoprotein antibody–associated encephalomyelitis: a case report and review of the literature
Authors: Di Nan
Ying Zhang
Jinming Han
Tao Jin
Publication date: 01-03-2021
Publisher: Springer International Publishing
Keywords: Anti-NMDA Receptor Encephalitis
Autoimmune Encephalitis
Encephalitis
Published in: Neurological Sciences / Issue 3/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04942-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Clinical features and management of coexisting anti-N-methyl-D-aspartate receptor encephalitis and myelin oligodendrocyte glycoprotein antibody–associated encephalomyelitis: a case report and review of the literature

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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