COVID-19 – a potential trigger for MOGAD-associated optic neuritis: a case report and literature review.

SARS-CoV-2 affects the nervous system directly by neurotoxic action, by binding to angiotensin-converting enzyme-2 (ACE2) receptors or indirectly by inducing cytokine storm leading to disruption of the blood-brain barrier, immunological mediation, increasing blood coagulation and as a trigger for au...

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Publicado en:Therapeutic Advances in Ophthalmology pp. 1 - 10
Autores principales: Bhardwaj, Ankit, Mishra, Hara Prasad, Goel, Ayush, Gupta, Ashi
Formato: case study diagnostic images pictorial tables/charts Journal Article
Publicado: Sage Publications Inc. 10/6/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 10/6/2023
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: COVID-19 – a potential trigger for MOGAD-associated optic neuritis: a case report and literature review.
      aug:
        au:
          Bhardwaj, Ankit
          Mishra, Hara Prasad
          Goel, Ayush
          Gupta, Ashi
        affil: Conceptualization, Department of Pharmacology, UCMS & GTB Hospital, Dilshad Garden, Delhi 110095, India
      sug:
        subj:
          Optic Neuritis Risk Factors
          COVID-19 Complications
          Central Nervous System Diseases Risk Factors
          Optic Neuritis Diagnosis
          Optic Neuritis Drug Therapy
          Methylprednisolone Therapeutic Use
          Immunoglobulins Administration and Dosage
          Administration, Intravenous
          Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Complications
          Adult
          Female
          Hematologic Tests
          Electrolytes
          Immunoglobulins Blood
          Electrophoresis
          Antibodies Blood
          Contrast Media Diagnostic Use
          Magnetic Resonance Imaging
          Brain Pathology
          Patient Discharge
          Treatment Outcomes
          Adult: 19-44 years
          Female
      ab: SARS-CoV-2 affects the nervous system directly by neurotoxic action, by binding to angiotensin-converting enzyme-2 (ACE2) receptors or indirectly by inducing cytokine storm leading to disruption of the blood-brain barrier, immunological mediation, increasing blood coagulation and as a trigger for autoimmune-mediated demyelinating injuries in the central nervous system. In COVID-19 neuro-ophthalmological manifestations are not so common. Optic neuritis is the result of optic nerve inflammation and has varied causes. In many patients, signs of inflammation are not visible on the fundus, and it usually manifests as papillitis-anterior neuritis, retrobulbar neuritis or visible optic nerve oedema. We are reporting a case of a middle-aged adult diagnosed with myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis of the right eye post-COVID-19 disease. Routine biochemical and haematological investigations, including electrolytes and hepatic and renal functions, were normal. In cerebrospinal fluid (CSF) – glucose 63.8 mg/dL, protein 39.1 mg/dL and ADA – 1 µ/L. No oligoclonal bands of immunoglobulin G (IgG) were seen on high-resolution electrophoresis. Serum Anti-MOG-antibodies were positive. A gadolinium-contrast magnetic resonance imaging (MRI) of the brain and orbits shows post-contrast enhancement in the superior aspect of the right intraconal soft tissue. The right optic nerve appears bulky and heterogeneous with peripheral post-contrast enhancement along its entire length suggestive of neuritis. A diagnosis of MOG antibody-positive optic neuritis was made, and the patient was treated with an injection of Methylprednisolone with intravenous immunoglobulin. Each day, the evaluation of the right eye showed remarkable improvement from finger counting to 6/6 vision. The patient was discharged on the 9th day of admission. We can conclude that early diagnosis was essential for improving the long-term outcome of the patient.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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