Related Experiment Video
Updated: Jun 16, 2025
Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4
Published on: August 21, 2017
Overlapping syndrome of anti-MOG antibody-associated disease and anti-mGluR5 encephalitis manifested as optic
Jianhang He1, Xiaoyan Niu, Xiaoyan Chen
1Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.
Rationale:
Anti-Myelin oligodendrocyte glycoprotein (MOG) and anti-metabotropic glutamate receptor 5 (mGluR5) double antibody positive encephalitis characterized by optic neuritis is extremely rare. We present a case of overlapping syndrome of MOG-IgG-associated disease and anti-mGluR5 encephalitis manifested as optic neuritis.
Patient Concerns:
A 60-year-old Chinses woman presented to the hospital with progressive vision loss and headache for 1 week. The cerebrospinal fluid examination was within the normal range. Visual evoked potentials study disclosed prolonged latency of P100 bilaterally. Fundus examination revealed indistinct boundaries of both optic discs. Her brain magnetic resonance imaging showed patchy hyperintensity in the posterior horn of the left ventricle and the left optic nerve. Her serum was positive for anti-MOG and anti-mGluR5 antibodies.
Diagnosis:
The patient was diagnosed with overlapping syndrome of anti-MOG antibody-associated disease and anti-mGluR5 encephalitis mainly based on the clinical symptoms and further test of the antibody in serum.
Interventions And Outcomes:
She was subsequently subjected to empirical treatment with intravenous methylprednisolone. After discharge, she was given a tapering dose of oral prednisone, alongside mycophenolate mofetil. On outpatient follow-up, her symptoms showed no relapse after 1 month, and her condition remained stable.
Lessons:
Early recognition of autoimmune encephalitis is crucial. The detection of cerebrospinal fluid and serum of autoimmune encephalitis and demyelinating diseases of the CNS, including MOG-IgG and mGluR5-IgG, should be strengthened in order to make a precise diagnosis and develop a comprehensive treatment plan in a timely manner.
Insights
This case highlights a rare double antibody encephalitis involving Myelin oligodendrocyte glycoprotein (MOG) and metatropic glutamate receptor 5 (mGluR5), presenting with optic neuritis. Early diagnosis and treatment are key for managing this overlapping autoimmune condition.
Area of Science:
- Neuroimmunology
- Neurology
Background:
- Anti-Myelin oligodendrocyte glycoprotein (MOG) and anti-metabotropic glutamate receptor 5 (mGluR5) double antibody positive encephalitis is an extremely rare condition.
- This study presents a unique case of overlapping syndrome of MOG-IgG-associated disease and anti-mGluR5 encephalitis.
Observation:
- A 60-year-old woman presented with a week of progressive vision loss and headache.
- Cerebrospinal fluid was normal, but visual evoked potentials showed bilateral P100 latency prolongation.
- Brain MRI revealed abnormalities in the left optic nerve and ventricle, with serum positive for anti-MOG and anti-mGluR5 antibodies.
Findings:
- The patient was diagnosed with overlapping MOG-IgG and anti-mGluR5 encephalitis based on clinical presentation and antibody testing.
- Treatment involved intravenous methylprednisolone, followed by oral prednisone and mycophenolate mofetil.
- The patient showed no relapse and remained stable at 1-month follow-up.
Implications:
- Early recognition and diagnosis of autoimmune encephalitis are crucial.
- Strengthening the detection of MOG-IgG and mGluR5-IgG in CSF and serum is vital for precise diagnosis and timely treatment of CNS demyelinating diseases and autoimmune encephalitis.
More Related Videos
10:19High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum
Published on: November 23, 2013
08:03Myelin Oligodendrocyte Glycoprotein MOG35-55 Induced Experimental Autoimmune Encephalomyelitis EAE in C57BL/6 Mice
Published on: April 15, 2014
