著者
高井 良樹 三須 建郎 藤原 一男 青木 正志
出版者
日本神経治療学会
雑誌
神経治療学 (ISSN:09168443)
巻号頁・発行日
vol.39, no.3, pp.282-288, 2022 (Released:2022-11-22)
参考文献数
51

MOG (Myelin oligodendrocyte glycoprotein) is a myelin protein expressed exclusively in the central nervous system (CNS). MOG has long been studied as a target antigen for autoimmune inflammatory demyelinating diseases of the CNS because of its distribution in the outermost layer of the myelin sheath and its structural features as a member of the immunoglobulin superfamily. Recently, the detection of conformation–sensitive MOG antibodies has led to the establishment of the clinical concept of MOG–antibody associated disease (MOGAD) as an independent autoimmune demyelinating disease. The clinical phenotypes include acute/multiphasic disseminated encephalomyelitis, optic neuritis, myelitis and brain stem and cerebral cortical encphalitis, whereas MOG antibodies are rarely detected in typical multiple sclerosis.The treatment of MOGAD is divided into acute and chronic phases. The acute treatment is mainly provided by high dose methylprednisolone. The response to the treatment is generally good, and most cases recover without severe sequelae. On the other hand, there is still no established treatment to relapse prevention. The currently accepted approach is to treat the acute phase of the disease followed by 3–6 months of oral steroid therapy, reassessment of MOG antibodies, and continued maintenance treatment in patients with persistent positive MOG antibodies. For patients who become negative for MOG antibodies, it may be appropriate to discontinue maintenance therapy and follow–up. However, the pathogenesis of MOGAD is complex, with variability in response to B–cell removal therapy between cases. We hoped that the pathophysiology of MOGAD will be further elucidated in the future.
著者
高井 良樹 飯野 佑一 堀口 淳
出版者
北関東医学会
雑誌
北関東医学 (ISSN:13432826)
巻号頁・発行日
vol.59, no.3, pp.255-258, 2009-08-01 (Released:2009-09-11)
参考文献数
6
被引用文献数
1

Mondor病は乳房およびその周囲の前胸壁に多く認められる浅在性の血栓性静脈炎で, 比較的まれな良性疾患である. 当院で3年10ヶ月の間に経験した41例のMondor病症例について検討した. 男女比は1 : 40. 年齢は26~73歳 (平均43.5歳) であった. 発生部位は右 : 左=14 : 27で左に多く, 上腹部から乳房部を経て腋窩に至る部に分布していた. 原因は35例 (85.4%) が特発性であった. 4例は乳癌手術の既往 (術後2ヶ月~ 2年4ヶ月) があり, 1例は乳腺生検後20日, 1例は授乳中であった. 症状は前胸壁皮膚の有痛性の索状物や皮膚陥凹である. ほとんどの症例は経過観察のみで1 ~ 2ヶ月で自然治癒した. Mondor病の診療で大切なのはこの病気について正しい知識を持ち, 他の乳腺疾患を否定することである.