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The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab
The phenotypic spectrum of myelin oligodendrocyte glycoprotein (MOG)- IgG–associated disorders (MOGAD) has broadened in the past few years, and atypical phenotypes are increasingly recognized. Isolated seizures and MRI-negative brainstem and cerebellar symptoms or encephalitis have rarely been repor...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463181/ https://www.ncbi.nlm.nih.gov/pubmed/37649484 http://dx.doi.org/10.3389/fimmu.2023.1183488 |
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author | Zhang, Rui Wang, Li Tao, Yongli Zhang, Xiaofeng Liu, Kai Song, Bo Xu, Yuming |
author_facet | Zhang, Rui Wang, Li Tao, Yongli Zhang, Xiaofeng Liu, Kai Song, Bo Xu, Yuming |
author_sort | Zhang, Rui |
collection | PubMed |
description | The phenotypic spectrum of myelin oligodendrocyte glycoprotein (MOG)- IgG–associated disorders (MOGAD) has broadened in the past few years, and atypical phenotypes are increasingly recognized. Isolated seizures and MRI-negative brainstem and cerebellar symptoms or encephalitis have rarely been reported as a feature of MOGAD and represent a diagnostic challenge. Meanwhile, the coexistence of MOG IgG and other CNS autoimmune antibodies is infrequent. We report a patient presented with isolated epileptic onset, relapsed with MRI-negative brainstem symptoms and MRI-negative encephalitis. He was positive for MOG IgG throughout the disease course while concomitant NMDAR IgG was not detected positive until second relapse. He showed decreasing response to conventional first-line therapy. The last relapse was during a COVID-19 epidemic with limited inpatient resources. Fortunately, he was ultimately controlled on subcutaneous ofatumumab, a novel fully humanized anti-CD20 mAb. This is the first report about subcutaneous ofatumumab treatment in MOG and NMDAR IgG double positive encephalitis with 12-month follow-up, depicting its potential as a therapeutic option. |
format | Online Article Text |
id | pubmed-10463181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104631812023-08-30 The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab Zhang, Rui Wang, Li Tao, Yongli Zhang, Xiaofeng Liu, Kai Song, Bo Xu, Yuming Front Immunol Immunology The phenotypic spectrum of myelin oligodendrocyte glycoprotein (MOG)- IgG–associated disorders (MOGAD) has broadened in the past few years, and atypical phenotypes are increasingly recognized. Isolated seizures and MRI-negative brainstem and cerebellar symptoms or encephalitis have rarely been reported as a feature of MOGAD and represent a diagnostic challenge. Meanwhile, the coexistence of MOG IgG and other CNS autoimmune antibodies is infrequent. We report a patient presented with isolated epileptic onset, relapsed with MRI-negative brainstem symptoms and MRI-negative encephalitis. He was positive for MOG IgG throughout the disease course while concomitant NMDAR IgG was not detected positive until second relapse. He showed decreasing response to conventional first-line therapy. The last relapse was during a COVID-19 epidemic with limited inpatient resources. Fortunately, he was ultimately controlled on subcutaneous ofatumumab, a novel fully humanized anti-CD20 mAb. This is the first report about subcutaneous ofatumumab treatment in MOG and NMDAR IgG double positive encephalitis with 12-month follow-up, depicting its potential as a therapeutic option. Frontiers Media S.A. 2023-08-15 /pmc/articles/PMC10463181/ /pubmed/37649484 http://dx.doi.org/10.3389/fimmu.2023.1183488 Text en Copyright © 2023 Zhang, Wang, Tao, Zhang, Liu, Song and Xu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Zhang, Rui Wang, Li Tao, Yongli Zhang, Xiaofeng Liu, Kai Song, Bo Xu, Yuming The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab |
title | The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab |
title_full | The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab |
title_fullStr | The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab |
title_full_unstemmed | The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab |
title_short | The case report of MOG and NMDAR IgG double positive encephalitis treated with subcutaneous ofatumumab |
title_sort | case report of mog and nmdar igg double positive encephalitis treated with subcutaneous ofatumumab |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463181/ https://www.ncbi.nlm.nih.gov/pubmed/37649484 http://dx.doi.org/10.3389/fimmu.2023.1183488 |
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