中国实用儿科杂志

中国实用儿科杂志 ›› 2025, Vol. 40 ›› Issue (4): 348-352.DOI: 10.19538/j.ek2025040615

• 病例报告 • 上一篇    

以长期发热为主要表现的抗髓鞘少突胶质细胞糖蛋白抗体相关疾病6例

  

  1. 山东大学附属儿童医院（济南市儿童医院）神经内科，山东  济南  250000 
  • 出版日期:2025-04-06 发布日期:2025-05-13
  • 通讯作者: 金瑞峰，电子信箱：13953174587@163.com

MOG antibody-associated disease with prolonged fever as the main presentation：report on six cases

  1. Department of  Neurology，Children’s Hospital Affiliated to Shandong University，Jinan  250000，China
  • Online:2025-04-06 Published:2025-05-13

摘要： 回顾性分析山东大学附属儿童医院2021年1月至2021年9月收治的6例抗髓鞘少突胶质细胞糖蛋白（MOG）抗体阳性的长期发热患儿临床表现、体格检查、辅助检查等资料，以探讨以长期发热为主要表现的MOG抗体相关疾病的临床特点。结果发现，6例均以长期发热为主要临床表现；查体仅1例巴氏征阳性。6例血常规白细胞计数均增高，为（19.8～34.0）×109/L，其中中性粒细胞占比为77.4%～89.9%；红细胞沉降率61～105 mm/h，C反应蛋白21.6～57.3 mg/L。脑脊液白细胞计数范围（15～180）×106/L。3例颅脑磁共振成像（MRI）存在炎性改变，其中1例在病程35 d出现丘脑及小脑炎性信号改变。2例MOG抗体滴度1∶100，3例MOG抗体滴度1∶32，1例MOG抗体滴度1∶320。由此可得，MOG抗体相关疾病可引起长期发热。

关键词: 发热, 不明原因, 脱髓鞘, 抗髓鞘少突胶质细胞糖蛋白抗体相关疾病, 脑炎

Abstract: A retrospective analysis was performed on the medical data of 6 children with positive anti-myelin oligodendrocyte glycoprotein （MOG） antibody and prolonged fever， who attended the Children's Hospital Affiliated to Shandong University from January 2021 to September 2021， in order to explore the clinical characteristics of MOG antibody-related diseases with prolonged fever as the main manifestation. The medical data included clinical manifestations， physical examinations， and auxiliary examinations.The results showed that all 6 cases had prolonged fever as the main clinical manifestation; only 1 case had a positive Babinski sign upon physical examination.In all 6 cases，the white blood cell（WBC）counts in blood routine were elevated，ranging from 19.8 to 34.0×109/L，with a neutrophil percentage of 77.4% to 89.9%; the erythrocyte sedimentation rate was between 61 and 105 mm/h， and the C-reactive protein was between 21.6 and 57.3 mg/L. WBC counts in the cerebrospinal fluid ranged from（15~180）×106/L.Inflammatory changes were observed in 3 cases in the brain magnetic resonance imaging （MRI） ， with 1 case showing inflammatory signal changes in the thalamus and cerebellum on day 35 of the disease course. Two cases had an MOG antibody titer of 1∶100，3 had an MOG antibody titer of 1∶32，and 1 had an MOG antibody titer of 1∶320.From this， it can be concluded that MOG antibody-related diseases can cause prolonged fever. 

Key words: fever, unknown origin, demyelination, anti-myelin oligodendrocyte glycoprotein antibody-associated disorders, encephalitis