And the titer of MOG-IgG was higher than before (Fig. by surgical biopsy 4 years earlier. This patient has been treated with tumor resection, postoperative radiation treatment and chemotherapy. After treatment, the patient was left with right limb weakness while other symptoms were improved. Recently, the intravenous steroid agent was used to treat this patient after being diagnosed with MOG-EM. Dizziness, vomiting, and vision loss have gone into remission. This patient did not relapse in 7 months after discharge. This patient is still being followed up at the outpatient clinic. And the patient will next be treated with azathioprine. Conclusions: In previous studies, polyclonal antibody has been found DL-AP3 in cancer patients, such as aquaporin-4 and MOG-IgG in astrocytoma patients. But the case of our study finds that astrocytoma can coexist with MOG-EM. Therefore, MOG-EM should not be excluded easily in astrocytoma patients when the relative antibody of encephalomyelitis is positive. Whats more, it reminds us that the pathogenesis of MOG-EM might be related to astrocytoma. Keywords: astrocytoma, encephalomyelitis, MOG-IgG, MRI, serum 1. Introduction Myelin oligodendrocyte glycoprotein antibody associated encephalomyelitis (MOG-EM) is an inflammatory DL-AP3 demyelinating disease of the central nervous system. In the earliest studies, MOG-EM was often misdiagnosed as multiple sclerosis (MS) or classified as one type of neuromyelitis optic spectrum disorders (NMOSDs), which is oligodendrocyte glycoprotein antibody positive. MOG-EM is similar with NMOSDs which consists of several syndromes, including optic neuritis, myelitis, acute brainstem syndrome, and acute disseminated encephalomyelitis. However, with the further exploration of demyelinating diseases, a lot of studies found that DL-AP3 immunopathogenesis of MOG-EM is different from aquaporin-4 antibody positive NMOSDs so that more and more experts classified MOG-EM as a separate disease category.[1] The differences are as follows[2C4]: with the exploration of previous immunological studies, MOG-IgG can directly cause the occurrence of demyelinating diseases; MOG-EM does not damage astrocytes and lacks aquaporin-4 (AQP4) -IgG-positive; MOG-EM and NMOSDs have different Mouse monoclonal to RAG2 histopathological features. The underlying pathogenesis might be relative to humoral immunity and antigen-antibody response which is still unclear. The analysis of MOG-EM is based on the evidence, including the symptoms, serological antibody, and magnetic resonance imaging (MRI).[1,5] Astrocytoma was defined as tumor which presents character of astrocyte differentiation. Astrocytoma accounts for about 30% of all intracranial tumors and more than 78% of gliomas. Astrocytoma happens mostly in frontal lobe, temporal lobe, thalamus, mind stem and cerebellar hemispheres.[6] Astrocytoma can present similar symptoms with MOG-EM. And the demonstration of MRI in astrocytoma makes it hard to differentiate astrocytoma from MOG-EM.[7] It is hard to diagnose between demyelination and malignancy with MRI and symptoms. Our DL-AP3 case reports a 49-year-old female with medical history of astrocytoma (WHO grade II, isocitrate dehydrogenase 1) for more than 4 years who was recently diagnosed with MOG-EM. This individual was diagnosed with astrocytoma by medical biopsy, and treated with tumor resection, postoperative radiation treatment and chemotherapy (temozolomide) 4 years DL-AP3 earlier. She developed the symptoms of MOG-EM, including dizziness, vomiting, and vision loss 2 months earlier. The medical symptoms and MRI are unable to provide adequate evidence for us to differentiate astrocytoma recurrence from MOG-EM. However, serum MOG-antibody, visual evoked potential (VEP), and restorative effect finally proved the analysis of MOG-EM. 2. Case demonstration 2.1. Recent medical history Demonstration: This patient is definitely a 49-year-old female who experienced received treatment with main complaint of right limb weakness and headache in hospital for the first time on August 16, 2017. The individuals right limb weakness continued to worsen one month before admission, and her headache occurred a week before admission. Physical exam, auxiliary examination, analysis, and treatment: Neurological exam presented right Hemiplegia (Muscle mass strength: level 3), and no another irregular neurological.
