Détail du document
Identifiant
doi:10.1186/s13256-023-04191-7...
Auteur
Gadama, Yohane Preez, Marié Carr, Jonathan Theron, Sarel Albertyn, Christine Ssebambulidde, Kenneth Saylor, Deanna Brey, Naeem Henning, FrancloLangue
enEditeur
BioMed Central
Catégorie
Medicine & Public Health
Année
2023
Date de référencement
18/10/2023
Mots clés
myelin oligodendrocyte glycoprotei... mogad opportunistic infections advanced hiv disease aquaporin-4 autoimmune diseases case report glycoprotein patient myelin oligodendrocyte mogad mog infection positive hiv antibodiesRésumé
Background Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently described autoimmune inflammatory disorder of the central nervous system (CNS).
There is limited data on the association between Human Immunodeficiency virus (HIV) infection and MOGAD.
We report three patients with HIV infection and myelin oligodendrocyte glycoprotein (MOG) antibodies in the setting of other central nervous system infections.
Case descriptions The first patient, a 44-year-old black African man, presented with acute disseminated encephalomyelitis (ADEM) with positive serum MOG antibodies.
He made a significant recovery with corticosteroids but had a quick relapse and died from sepsis.
The second patient, an 18-year-old black woman, presented with paraplegia and imaging revealed a longitudinally extensive transverse myelitis and had positive serum MOG antibodies.
She remained paraplegic after methylprednisone and plasmapheresis treatments.
Her rehabilitation was complicated by development of pulmonary embolism and tuberculosis.
The third patient, a 43-year-old mixed-race woman, presented with bilateral painless visual loss.
Her investigations were notable for positive MOG antibodies, positive Varicella Zoster Virus on cerebral spinal fluid (CSF) and hyperintense optic nerves on magnetic resonance imaging (MRI).
Her vision did not improve with immunosuppression and eventually died from sepsis.
Conclusion Our cases illustrate the diagnostic and management challenges of MOGAD in the setting of advanced HIV infection, where the risk of CNS opportunistic infections is high even without the use of immunosuppression.
The atypical clinical progression and the dilemmas in the diagnosis and treatment of these cases highlight gaps in the current knowledge of MOGAD among people with HIV that need further exploration.
Gadama, Yohane,Preez, Marié,Carr, Jonathan,Theron, Sarel,Albertyn, Christine,Ssebambulidde, Kenneth,Saylor, Deanna,Brey, Naeem,Henning, Franclo, 2023, Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and Human Immunodeficiency virus infection: dilemmas in diagnosis and management: a case series, BioMed Central
Configurable Safety Tuning of Language Models with Synthetic Preference Data
data preference cst dpo configurable language safety
Affective flexibility as a developmental building block of cognitive reappraisal: An fMRI study
cognitive success affective flexibility
