Table 1 The clinical features of the three patients
Patient | Patient 1 | Patient 2 | Patient 3 |
|---|---|---|---|
Age(yrs), Sex | 9,M | 5,F | 6,F |
Symptoms upon admission (Prodromal symptom) and duration | Fever and cough, 2d | Fever and cough, 3d | Fever and cough, 4d |
Neurological manifestations and days after admission | Headache, Vomiting, Orbital pain, 8d | Headache, Vomiting, T Seizure, 11d | Seizure, hypersomnia, positive Babinski sign,8d |
Nasopharyngeal MP PCR | Positive | Positive | Positive |
Serum MP-IgM(reference < 1:80) | 1:160 | 1:1280 | 1:640 |
Pulmonary X-ray | bronchitis | bronchitis | bronchitis |
CSF | |||
LEU(reference < 15*10^6/L)/(mon%) | 71 /(82%) | 111/(90%) | 55/(80%) |
Protein(reference 150-450 mg/L) | 404 | 372 | 293 |
Glucose(reference 2.5–4.5 mmol/L) | 3.6 | 4.3 | 3.9 |
MP PCR | negative | negative | negative |
Cranial MRI | Abnormal (Fig. 1 a) | Abnormal (Fig. 1b) | Abnormal (Fig. 1 c) |
EEG | slow background | normal | normal |
Serum MOG-IgG | 1:320 | 1:32 | 1:320 |
Antibiotics, dose and duration | Erythromycin, 20 mg/kg.d, 10d | Erythromycin, 20 mg/kg.d, 14d | Erythromycin, 20 mg/kg.d, 10d |
IVIG dose | 1 g/kg.d × 2d | 1 g/kg.d × 2d | 1 g/kg.d × 2d |
IV methylprednisolone dose and duration | 20 mg/kg.d × 5 d | 20 mg/kg.d × 5 d | 20 mg/kg.d × 5 d |
Follow-up | |||
Duration of Steroid | 3 m | 3 m | 4 m |
Clinical manifestation | completely recovered | completely recovered | completely recovered |
EEG | normal | normal | normal |
Cranial MRI (after discharge) | Normal (8 m) | Normal (6 m) | Normal (7 m) |
Serum MOG-IgG (after discharge) | 1:32 (4 m)/ 1:10(6 m) Negative(8 m) | 1:10 (3 m) Negative(6 m) | 1:10 (5 m) Negative(7 m) |