脊髄灰白質病変を伴った抗myelin-oligodendrocyte glycoprotein（MOG）抗体関連疾患の1例

A case of MOG antibody disease with spinal cord gray matter lesions

抗myelin-oligodendrocyte glycoprotein（MOG）抗体とは，中枢神経系におけるオリゴデンドロサイトの髄鞘の構成蛋白であるMOGに対してできる自己抗体である。抗MOG抗体による自己免疫性疾患は，中枢神経で多様な表現型を呈することが知られている。今回，我々は脊髄灰白質病変を伴った抗MOG抗体関連疾患の1例を経験したので文献的考察を加えて報告する。

An 11-year-old girl was admitted to our hospital with a fever of unknown origin and lightheadedness. T2-weighted MR images showed hyperintense lesions in the bilateral thalamus, corpus callosum, subcortical white matter, cortex, and spinal cord. In the spinal cord, H-shaped T2-hyperintensity outlining the gray matter was observed in axial sections. This “H-sign” has been reported as more commonly seen in myelin-oligodendrocyte glycoprotein（MOG）antibody diseases than in anti-Aquaporin4（AQP4）antibody-positive myelitis, and was not seen in multiple sclerosis. When “H-sign” is observed in the spinal cord, as in this case, measurement of anti-MOG antibody is required.