Neuromyelitis optica (Devic's disease) in a patient with syphilis.
The patient initially presented with bilateral optic neuritis and periventricular cranial MRI abnormalities in the context of syphilis. Blood was positive but cerebrospinal fluid testing was negative for specific syphilis markers and he was oligoclonal cerebrospinal fluid (CSF) band negative. He initially responded well to penicillin and corticosteriod treatment, but went on to develop the clinical syndrome of neuromyelitis optica (NMO). Testing for the presence of the serum autoantibody for aquaporin-4 was negative. This patient appears to represent another case of post-infectious NMO. Possible pathogenesis of this post-syphilis NMO syndrome in the patient is discussed.
Wilcox
Robert A
RA
Department of Neurology, Flinders Medical Centre, Bedford Park, SA, 5041, Australia. robert_wilcox@health.qld.gov.au
Burrow
James
J
Slee
Mark
M
Craig
Jamie
J
Thyagarajan
Dominic
D
D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009471:Neuromyelitis Optica / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D009494:Neurosyphilis / Q000150:complications* / Q000276:immunology / Q000473:pathology
C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies