髓鞘寡突膠質細胞醣蛋白抗體相關疾病之病例報告

A Case Report of Myelin Oligodendrocyte Glycoprotein Antibody- Associated Disease

髓鞘寡突膠質細胞糖蛋白抗體相關疾病（myelin oligodendrocyte glycoprotein antibody-associated disease, MOGAD），是一種與中樞神經系統脫髓鞘病變相關的自身免疫疾病，臨床表現多樣，包括視神經炎、橫貫性脊髓炎及急性播散性腦脊髓炎。本報告描述一位44歲女性，雙眼視力模糊長達3天未緩解，至急診求醫。經由腦部磁振造影檢查呈現雙側視神經和神經鞘出現增強顯影，初步懷疑視神經炎和神經周圍炎，後續AQP4抗體陰性，MOG抗體檢驗為陽性，確診為MOGAD。經類固醇治療後神經功能部分恢復，後續使用口服類固醇控制。本病例強調MOG抗體檢測在鑑別診斷中之重要性，並探討其臨床意涵與治療策略。

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune disorder associated with central nervous system demyelination. Its clinical manifestations are diverse, including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis (ADEM). This report describes a 44-year-old woman who presented to the emergency department with bilateral blurred vision persisting for three days. Brain MRI revealed bilateral enhancement of the optic nerves and their sheaths, initially raising suspicion for optic neuritis and perineuritis. Serologic testing was negative for Anti-aquaporin-4 antibodies but positive for MOG antibodies, confirming the diagnosis of MOGAD. Following corticosteroid therapy, the patient experienced partial neurological recovery and continued on oral steroids for disease control. This case highlights the importance of MOG antibody testing in differential diagnosis and discusses its clinical implications and therapeutic strategies.