Acta Neuropathologica: MOG expression teratoma secondary MOG-IgG positive optic neuritis.

Sub-tumor ethonology was reported in a small number of patients with water channel protein-4 (AQP4)-IgG serotonin-positive optic neurospinalitis spectrum disorder (NMOSD), with lung and breast cancer being the most common associated malignancies.
MOG encephalomyelitis (MOG-EM; also known as MOG antibody-related disease (MOGAD)) is a rare autoimmune disease characterized by immunoglobulin G antibodies (IgGs) of serum anti-myelin-less protrusion glial glycogen (MOG), clinical and radiological characteristics that overlap with NMOSD and multiple sclerosis (MS) and may occur in a side tumor environment, which is not yet known.
we reported a MOG-EM patient with mild symptoms months after an ovarian teratoma was discovered and removed.
pathology showed that the nerve tissue in the teratoma expressed MOG protein, accompanied by immunocellular immersion, suggesting that MOG-EM in this case may be the origin of the by-tumor.
26-year-old woman with a history of Hashimoto's thyroiditis has been suffering from right abdominal pain for weeks.
pelvic MRI showed a 6 cm diameter lump near the right ovary, showing sebum gland composition and calcification.
the right ovary, histology proved to be a mature cystic teratoma.
11 months, the patient had left optic neuritis within 3 weeks of the upper respiratory tract infection.
symptoms include mild eye pain, blurred vision, impaired color perception, and a drop in vision to 0.6.
head magnetic resonance imaging (MRI) showed a normal optic nerve and an isolated small T2/liquid attenuation reversal to restore lesions in the right frontal leaf whiteness;
cerebrospinal fluid analysis showed a normal cell and protein spectrum, with no oligoclonal bands.
AQP4-IgG and NMDA subject IgG serologically negative, while MOG-IgG serologically positive (1:320).
moG-IgG is negative in the cerebrospinal fluid, just like MOG-EM.
tested positive for serum in three cell-based tests using fixed or living cells expressing the recombinant human full-length MOG protein, two of which used Fc(γ) specific secondary antibodies.
after taking high doses of intravenous methamphetrometron (IVMP) (5×1000 mg) and oral for more than 4 weeks (initially 60 mg/d).
5 months, the patient noticed a recurrence of pain during eye movement, blurred vision on the left side, consistent with a second onset on the left side.
the skull MRI, repeated lumbar puncture with the exception of a few activated lymphocytes, no abnormalities.
MOG-IgG can be detected at low titration (1:32; cut-off value 1:10).
vision recovered after IVMP (3×1000mg) treatment, and mild damage to color perception continues to this day.
a few months after the second operation, further pelvic MRI examinations showed no evidence of relapsed teratomas.
2 months and 4 months after the second seizure, 18 months and 20 months after the teratoma was removed, and moG-IgG was negative according to three tests.
to investigate the possible sub-tumor origin of moG-EM in this patient, we conducted a neuropathological examination of the tissue block of the teratoma, whose histological studies showed that it was mainly cystic mature teratoma.
summary, in view of recent observations that NMDAR-IgG-positive encephalitis is closely related to teratomas and reports of by-tumor NMOSD, it is necessary to systematically assess the prevalence of teratomas in MMG-IgG-positive adult women.
our findings support the recommendation to detect MOG-IgG in patients with central nervous system demyelination and co-existing teratomas.
Willemann, B., Jarius, S., Franz, J. et al. MOG expressing teratoma by MOG-IgG-positive optic neuritis. Acta Neuropathol (2020). MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual, and are authorized to be reproduced with the words "Source: Mets Medicine".
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