Оптикомиелит, ассоциированный с наличием антител к гликопротеину миелиновых олигодендроцитов. Клинический случай

Калашникова А.К., Шеремет Н.Л., Андреева Н.А., Жоржоладзе Н.В., Ронзина И.А, Калошина А.А. Оптикомиелит, ассоциированный с наличием антител к гликопротеину миелиновых олигодендроцитов. Клинический случай. Consilium Medicum. 2022;24(2):132–136. DOI: 10.26442/20751753.2022.2.201391

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Kalashnikova AK, Sheremet NL, Andreeva NA, Zhorzholadze NV, Ronzina IA, Kaloshina AA. Optomyelitis associated with the presence of antibodies to myelin oligodendrocyte glycoprotein. Case report. Consilium Medicum. 2022;24(2):132–136. DOI: 10.26442/20751753.2022.2.201391

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Аннотация

Антитела к миелин-олигодендроцитарному гликопротеину (анти-MOG-IgG) – это специфический биомаркер, который обнаружен в периферической крови у детей с острым рассеянным энцефаломиелитом, а также у взрослых с аквапорином-4 (AQP4), ассоциированным с серонегативным заболеванием спектра оптиконейромиелита, энцефалитом ствола мозга, продольно распространенным поперечным миелитом и невритом зрительного нерва. Большинство экспертов в настоящее время считают MOG-IgG – ассоциированное расстройство (МОГ-АР) самостоятельным заболеванием, иммунопатогенетически отличным от классического рассеянного склероза (РС) и AQP4-IgG-положительного оптикомиелита. Изолированный, двусторонний, реже односторонний оптический неврит с одновременным или последовательным вовлечением глаз является наиболее частым клиническим проявлением МОГ-АР. Из-за существенного совпадения клинико-радиологической картины МОГ-АР часто ошибочно диагностируется как РС. Своевременно установленный диагноз имеет решающее значение для обеспечения надлежащего лечения. В статье описан клинический случай анти-MOG-IgG-энцефаломиелита с поздним присоединением оптического неврита, изначально диагностированный как РС.

Ключевые слова: расстройство, ассоциированное с антителами к миелин-олигодендроцитарному гликопротеину, антитела к миелин-олигодендроцитарному гликопротеину, заболевания спектра оптиконейромиелита, рассеянный склероз, оптический неврит

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Antibodies to myelin-oligodendrocyte glycoprotein (anti-MOG-IgG) is a specific biomarker that has been detected in peripheral blood from children with acute multiple encephalomyelitis (ADEM) as well as in adults with aquaporin-4 (AQP4), associated with seronegative opticoneuromyelitis spectrum disease (NMOSD), brainstem encephalitis, longitudinally disseminated transverse myelitis, and optic neuritis. Most experts now consider MOG-IgG-associated disorder (MOG-AD) an independent disease immunopathogenetically distinct from classical multiple sclerosis (MS) and aquaporin-4 (AQP4)-IgG-positive optomyelitis. Isolated, bilateral, and less frequently unilateral OH, with simultaneous or sequential involvement of the eyes, is the most frequent clinical manifestation of MOG-AD. Because of the significant overlap in the clinical and radiological picture, MOG-AD is often misdiagnosed as MS. Timely diagnosis is critical to ensure appropriate treatment. This article describes a clinical case of anti-MOG-IgG encephalomyelitis with late-onset ON initially diagnosed as MS.

Keywords: myelin oligodendrocyte glycoprotein antibody-associated disease, anti-myelin oligodendrocyte glycoprotein antibodies, neuromyelitis optica spectrum disorders, multiple sclerosis, optic neuritis

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Список литературы

1. Voss E, Raab P, Trebst C, Stangel M. Clinical approach to optic neuritis: pitfalls, red flags and differential diagnosis. Ther Adv Neurol Disord. 2011;4(2):123-34. DOI:10.1177/1756285611398702
2. Petzold A, Plant GT. Diagnosis and classification of autoimmune optic neuropathy. Autoimmun Rev. 2014;13(4-5):539-45. DOI:10.1016/j.autrev.2014.01.009
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6. Nakajima H, Motomura M, Tanaka K, et al. Antibodies to myelin oligodendrocyte glycoprotein in idiopathic optic neuritis. BMJ Open. 2015;5(4):e007766.
DOI:10.1136/bmjopen-2015-007766
7. Sepúlveda M, Armangue T, Martinez-Hernandez E, et al. Clinical spectrum associated with MOG autoimmunity in adults: significance of sharing rodent MOG epitopes. J Neurol. 2016;263(7):1349-60. DOI:10.1007/s00415-016-8147-7
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13. Zheng Y, Cai MT, Li EC, et al. Case Report: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder Masquerading as Multiple Sclerosis: An Under-Recognized Entity? Front Immunol. 2021;12:671425. DOI:10.3389/fimmu.2021.671425
14. Bonnan M, Valentino R, Debeugny S, et al. Short delay to initiate plasma exchange is the strongest predictor of outcome in severe attacks of NMO spectrum disorders. J Neurol Neurosurg Psychiatry. 2018;89(4):346-51. DOI:10.1136/jnnp-2017-316286
15. Juryńczyk M, Tackley G, Kong Y, et al. Brain lesion distribution criteria distinguish MS from AQP4-antibody NMOSD and MOG-antibody disease. J Neurol Neurosurg Psychiatry. 2017;88(2):132-6. DOI:10.1136/jnnp-2016-314005
16. Dubey D, Pittock SJ, Krecke KN, et al. Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody. JAMA Neurol. 2019;76(3):301. DOI:10.1001/jamaneurol.2018.4053
17. Ciron J, Cobo-Calvo A, Audoin B, et al. Frequency and characteristics of short versus longitudinally extensive myelitis in adults with MOG antibodies: A retrospective multicentric study. Mult Scler. 2020;26(8):936-44. DOI:10.1177/1352458519849511
18. Ramanathan S, Mohammad S, Tantsis E, et al. Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination. J Neurol Neurosurg Psychiatry. 2018;89(2):127-37. DOI:10.1136/jnnp-2017-316880
19. Fang W, Zheng Y, Yang F, et al. Short segment myelitis as the initial and only manifestation of aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorders. Ther Adv Neurol Disord. 2020;13:175628641989859. DOI:10.1177/1756286419898594
20. Jarius S, Ruprecht K, Kleiter I, et al. Mog-IgG in NMO and Related Disorders: A Multicenter Study of 50 Patients. Part 1: Frequency, Syndrome Specificity, Influence of Disease Activity, Long-Term Course, Association With AQP4-IgG, and Origin. J Neuroinflammation. 2016;13(1):279. DOI:10.1186/s12974-016-0717-1
21. Brayo P, Shah S. MOG-IgG Associated Disease (MOG-AD) in Adults. Curr Treat Options Neurol. 2021;23(6):17. DOI:10.1007/s11940-021-00672-6
22. Narayan RN, McCreary M, Conger D, et al. Unique characteristics of optical coherence tomography (OCT) results and visual acuity testing in myelin oligodendrocyte glycoprotein (MOG) antibody positive pediatric patients. Mult Scler Relat Disord. 2019;28:86-90. DOI:10.1016/j.msard.2018.11.026
23. Outteryck O, Majed B, Defoort-Dhellemmes S, et al. A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis. Mult Scler. 2015;21(14):1781-93. DOI:10.1177/1352458515578888
24. Havla J, Pakeerathan T, Schwake C, et al. Age-dependent favorable visual recovery despite significant retinal atrophy in pediatric MOGAD: how much retina do you really need to see well? J Neuroinflammation. 2021;18(1):121. DOI:10.1186/s12974-021-02160-9
25. Filippatou AG, Mukharesh L, Saidha S, et al. AQP4-IgG and MOG-IgG Related Optic Neuritis–Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11:540156. DOI:10.3389/fneur.2020.540156
26. Jarius S, Ruprecht K, Kleiter I, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflammation. 2016;13(1):280. DOI:10.1186/s12974-016-0718-0
27. Stiebel-Kalish H, Hellmann MA, Mimouni M, et al. Does time equal vision in the acute treatment of a cohort of AQP4 and MOG optic neuritis? Neurol Neuroimmunol Neuroinflamm. 2019;6(4):e572. DOI:10.1212/NXI.0000000000000572
28. Peschl P, Bradl M, Höftberger R, et al. Myelin Oligodendrocyte Glycoprotein: Deciphering a Target in Inflammatory Demyelinating Diseases. Front Immunol. 2017;8:529. DOI:10.3389/fimmu.2017.00529
29. Chen JJ, Flanagan EP, Jitprapaikulsan J, et al. Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome. Am J Ophthalmol. 2018;195:8-15. DOI:10.1016/j.ajo.2018.07.020
30. Ringelstein M, Ayzenberg I, Lindenblatt G, et al. Interleukin-6 Receptor Blockade in Treatment-Refractory MOG-IgG-Associated Disease and Neuromyelitis Optica Spectrum Disorders. Neurol Neuroimmunol Neuroinflamm. 2022;9(1):e1100. DOI:10.1212/NXI.0000000000001100

________________________________________________

1. Voss E, Raab P, Trebst C, Stangel M. Clinical approach to optic neuritis: pitfalls, red flags and differential diagnosis. Ther Adv Neurol Disord. 2011;4(2):123-34. DOI:10.1177/1756285611398702
2. Petzold A, Plant GT. Diagnosis and classification of autoimmune optic neuropathy. Autoimmun Rev. 2014;13(4-5):539-45. DOI:10.1016/j.autrev.2014.01.009
3. Weerasinghe D, Lueck C. Mimics and chameleons of optic neuritis. Pract Neurol. 2016;16(2):96-110. DOI:10.1136/practneurol-2015-001254
4. Chen JJ, Pittock SJ, Flanagan EP, et al. Optic neuritis in the era of biomarkers. Surv Ophthalmol. 2020;65(1):12-7. DOI:10.1016/j.survophthal.2019.08.001
5. Di Pauli F, Berger T. Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorders: Toward a New Spectrum of Inflammatory Demyelinating CNS Disorders? Front Immunol. 2018;9:2753. DOI:10.3389/fimmu.2018.02753
6. Nakajima H, Motomura M, Tanaka K, et al. Antibodies to myelin oligodendrocyte glycoprotein in idiopathic optic neuritis. BMJ Open. 2015;5(4):e007766.
DOI:10.1136/bmjopen-2015-007766
7. Sepúlveda M, Armangue T, Martinez-Hernandez E, et al. Clinical spectrum associated with MOG autoimmunity in adults: significance of sharing rodent MOG epitopes. J Neurol. 2016;263(7):1349-60. DOI:10.1007/s00415-016-8147-7
8. Akaishi T, Sato DK, Takahashi T, Nakashima I. Clinical spectrum of inflammatory central nervous system demyelinating disorders associated with antibodies against myelin oligodendrocyte glycoprotein. Neurochem Int. 2019;130:104319. DOI:10.1016/j.neuint.2018.10.016
9. Jarius S, Paul F, Aktas O, et al. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. J Neuroinflammation. 2018;15(1):134. DOI:10.1186/s12974-018-1144-2
10. Eliseeva DD, Vasiliev AV, Shabalina AA, et al. Myelin oligodendrocyte glycoprotein immunoglobulin G-associated encephalomyelitis. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2020;120(7-2):13-23 (in Russian). DOI:10.17116/jnevro202012007213
11. Jurynczyk M, Messina S, Woodhall MR, et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study. Brain. 2017;140(12):3128-38. DOI:10.1093/brain/awx276
12. Shchepareva ME, Kochergin IA, Tolpeeva OA, et al. Diagnostic value of antibodies to myelin oligodendrocyte glycoprotein in demyelinating diseases of the central nervous system. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2019;119(2-2):18-23 (in Russian).
13. Zheng Y, Cai MT, Li EC, et al. Case Report: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder Masquerading as Multiple Sclerosis: An Under-Recognized Entity? Front Immunol. 2021;12:671425. DOI:10.3389/fimmu.2021.671425
14. Bonnan M, Valentino R, Debeugny S, et al. Short delay to initiate plasma exchange is the strongest predictor of outcome in severe attacks of NMO spectrum disorders. J Neurol Neurosurg Psychiatry. 2018;89(4):346-51. DOI:10.1136/jnnp-2017-316286
15. Juryńczyk M, Tackley G, Kong Y, et al. Brain lesion distribution criteria distinguish MS from AQP4-antibody NMOSD and MOG-antibody disease. J Neurol Neurosurg Psychiatry. 2017;88(2):132-6. DOI:10.1136/jnnp-2016-314005
16. Dubey D, Pittock SJ, Krecke KN, et al. Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody. JAMA Neurol. 2019;76(3):301. DOI:10.1001/jamaneurol.2018.4053
17. Ciron J, Cobo-Calvo A, Audoin B, et al. Frequency and characteristics of short versus longitudinally extensive myelitis in adults with MOG antibodies: A retrospective multicentric study. Mult Scler. 2020;26(8):936-44. DOI:10.1177/1352458519849511
18. Ramanathan S, Mohammad S, Tantsis E, et al. Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination. J Neurol Neurosurg Psychiatry. 2018;89(2):127-37. DOI:10.1136/jnnp-2017-316880
19. Fang W, Zheng Y, Yang F, et al. Short segment myelitis as the initial and only manifestation of aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorders. Ther Adv Neurol Disord. 2020;13:175628641989859. DOI:10.1177/1756286419898594
20. Jarius S, Ruprecht K, Kleiter I, et al. Mog-IgG in NMO and Related Disorders: A Multicenter Study of 50 Patients. Part 1: Frequency, Syndrome Specificity, Influence of Disease Activity, Long-Term Course, Association With AQP4-IgG, and Origin. J Neuroinflammation. 2016;13(1):279. DOI:10.1186/s12974-016-0717-1
21. Brayo P, Shah S. MOG-IgG Associated Disease (MOG-AD) in Adults. Curr Treat Options Neurol. 2021;23(6):17. DOI:10.1007/s11940-021-00672-6
22. Narayan RN, McCreary M, Conger D, et al. Unique characteristics of optical coherence tomography (OCT) results and visual acuity testing in myelin oligodendrocyte glycoprotein (MOG) antibody positive pediatric patients. Mult Scler Relat Disord. 2019;28:86-90. DOI:10.1016/j.msard.2018.11.026
23. Outteryck O, Majed B, Defoort-Dhellemmes S, et al. A comparative optical coherence tomography study in neuromyelitis optica spectrum disorder and multiple sclerosis. Mult Scler. 2015;21(14):1781-93. DOI:10.1177/1352458515578888
24. Havla J, Pakeerathan T, Schwake C, et al. Age-dependent favorable visual recovery despite significant retinal atrophy in pediatric MOGAD: how much retina do you really need to see well? J Neuroinflammation. 2021;18(1):121. DOI:10.1186/s12974-021-02160-9
25. Filippatou AG, Mukharesh L, Saidha S, et al. AQP4-IgG and MOG-IgG Related Optic Neuritis–Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis. Front Neurol. 2020;11:540156. DOI:10.3389/fneur.2020.540156
26. Jarius S, Ruprecht K, Kleiter I, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflammation. 2016;13(1):280. DOI:10.1186/s12974-016-0718-0
27. Stiebel-Kalish H, Hellmann MA, Mimouni M, et al. Does time equal vision in the acute treatment of a cohort of AQP4 and MOG optic neuritis? Neurol Neuroimmunol Neuroinflamm. 2019;6(4):e572. DOI:10.1212/NXI.0000000000000572
28. Peschl P, Bradl M, Höftberger R, et al. Myelin Oligodendrocyte Glycoprotein: Deciphering a Target in Inflammatory Demyelinating Diseases. Front Immunol. 2017;8:529. DOI:10.3389/fimmu.2017.00529
29. Chen JJ, Flanagan EP, Jitprapaikulsan J, et al. Myelin Oligodendrocyte Glycoprotein Antibody–Positive Optic Neuritis: Clinical Characteristics, Radiologic Clues, and Outcome. Am J Ophthalmol. 2018;195:8-15. DOI:10.1016/j.ajo.2018.07.020
30. Ringelstein M, Ayzenberg I, Lindenblatt G, et al. Interleukin-6 Receptor Blockade in Treatment-Refractory MOG-IgG-Associated Disease and Neuromyelitis Optica Spectrum Disorders. Neurol Neuroimmunol Neuroinflamm. 2022;9(1):e1100. DOI:10.1212/NXI.0000000000001100

Авторы

А.К. Калашникова*1, Н.Л. Шеремет2, Н.А. Андреева2, Н.В. Жоржоладзе2, И.А. Ронзина2, А.А. Калошина2

1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБНУ «Научно-исследовательский институт глазных болезней», Москва, Россия
*kalashnic94@yandex.ru

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Anastasiia K. Kalashnikova*1, Nataliia L. Sheremet2, Natalia A. Andreeva2, Nino V. Zhorzholadze2, Irina A. Ronzina2, Anna A. Kaloshina2

1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Research Institute of Eye Diseases, Moscow, Russia
*kalashnic94@yandex.ru

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