Neuromyelitis optica spectrum disorder and systemic lupus erythematosus

Abstract

Neuromyelitis optica spectrum disorder is an inflammatory syndrome that is associated with many autoimmune conditions. We present the case of a patient who had longitudinally extensive transverse myelitis and antibodies to aquaporin 4 IgG (AQP4-IgG). Based on presence of lymphopenia, further workup revealed strong ANA positivity, anti-Sm antibodies, and low serum complements suggesting presence of systemic lupus erythematosus. The patient promptly responded to intravenous pulse methylprednisolone and five sessions of plasma exchange. At 1 year, she is on maintenance treatment with low dose prednisolone, azathioprine, and hydroxychloroquine, she has had no relapse and no other clinical features of lupus. This case is an illustration that neuromyelitis optica spectrum disorder can be the first manifestation of systemic lupus erythematosus.

Neuromyelitis optica spectrum disorder co‐existing with antiphospholipid syndrome: A case report

“…The co‐existence with the antiphospholipid syndrome, in this case, was supported by a history of recurrent pregnancy loss and antiphospholipid antibody seropositivity 27 . The index case correlated with a few published cases regarding their pathogenic domains, clinical presentations, diagnostic criteria, and management approaches 12,30–32 . Despite the rarity of the disease and scarcity of published data in our settings, it was very challenging to diagnose and manage NMOSD, especially when co‐existing with other autoimmune conditions.…”

“… 27 The index case correlated with a few published cases regarding their pathogenic domains, clinical presentations, diagnostic criteria, and management approaches. 12 , 30 , 31 , 32 Despite the rarity of the disease and scarcity of published data in our settings, it was very challenging to diagnose and manage NMOSD, especially when co‐existing with other autoimmune conditions. This case highlighted the importance of broadening differentials among clinicians in any case with a component of autoimmunity.…”

Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy Associated With Area Postrema Syndrome: A Case Report

“…Our patient specifically presented with higher levels of thyroglobulin and thyroperoxidase-specific antibodies. Consequently, considering the prevalence and adverse effects of autoimmune conditions in the disease (7), comprehensive antibody screening should be conducted. In addition, the symptom improvement observed in our patient after high-dose corticosteroids further solidify the mainstream hypothesis that sensitivity to corticosteroids is a hallmark of the disease (2).…”