Figura 1. Frecuencia de presentación de fenotipos de la enfermedad por anticuerpos antiglucoproteína del oligodendrocito asociado a la mielina [10]. ADEM: encefalomielitis aguda diseminada; MTLE: mielitis transversa longitudinalmente extensa; NO: neuritis óptica.
Figura 2. Algoritmo de enfoque diagnóstico y terapéutico de enfermedad por anticuerpos antiglucoproteína del oligodendrocito asociado a la mielina. ADEM: encefalomielitis aguda diseminada; AQP4: acuaporina 4; LCR: líquido cefalorraquídeo; MT: mielitis transversa; MTLE: mielitis transversa longitudinalmente extensa; NMOSD: espectro de enfermedad de neuromielitis óptica; NO: neuritis óptica.
Tabla. Efectos adversos de medicamentos usados en la enfermedad por anticuerpos antiglucoproteína del oligodendrocito asociado a la mielina [67]. |
|
Prednisolona |
Ganancia de peso, cataratas, hipertensión, trombosis, osteoporosis, infecciones, hiperglucemia, gastritis, úlcera péptica, trastornos psiquiátricos, síndrome de Cushing |
Azatioprina |
Depresión de la medula ósea, anemia, leucopenia, trombopenia, infección fúngica o vírica, disfunción hepática, náusea, emesis, malignomas, leucoencefalopatía multifocal progresiva |
Rituximab |
Síntomas asociados a la transfusión (prurito, cefalea, rash, fiebre), síndrome de Lyell, síndrome de Stevens-Johnson, arritmias, insuficiencia cardíaca aguda, hipogammaglobulinemia |
Micofenolato |
Leucopenia, diarrea, vómito, sepsis, neoplasias |
Inmunoglobulina |
Cefalea, meningismo, anafilaxis |
Metotrexato |
Náuseas, diarrea, depresión de la medula ósea, disfunción hepática |
Clinical presentation of the spectrum of myelin oligodendocryte glycoprotein antibody disease Introduction. Myelin oligodendrocyte glycoprotein (MOG) antibody disease is a rare and practically new entity in medicine. In developing countries, there are still important limitations for the detection of anti-MOG antibodies by cell-based assay, so knowing the clinical characteristics of the different phenotypes and their differences with other demyelinating pathologies of the central nervous system is essential in order to make a proper diagnostic and therapeutic approach of the patients. Aim. To present an update regarding the clinical characteristics of the disease spectrum, being the first article in Spanish that gathers the most frequent phenotypes and provides a clear description of what should be considered to identify each of these phenotypes. Development. This disease is characterized by having a monophasic or recurrent course, with optic neuritis being the most frequent presentation phenotype in general population and disseminated acute encephalomyelitis the most frequent in children. Other phenotypes described in this review are transverse myelitis, focal cortical encephalitis and cerebral stem syndromes, as well as the proposed criteria for the diagnosis of the disease associated with MOG antibody disease. Conclusion. Currently there are no studies that seek to characterize the Spanish-speaking population with this disease, or review articles in Spanish, so it is important to disseminate knowledge and develop research in this area. Key words. Disseminated acute encephalomyelitis. Encephalitis. MOG. Myelin-oligodendrocyte glycoprotein. Optic neuritis. Transverse myelitis. |