A case of longitudinally extensive transverse myelitis (LETM): neuromyelitis optica.
Neuromyelitis optica (NMO), characterised by longitudinally extensive transverse myelitis (LETM), was previously thought to be a variant of multiple sclerosis. Transverse myelitis may be a manifestation of autoimmune connective tissue diseases and NMO is now recognised to be a humorally mediated autoimmune disease. We present a case of NMO associated with non-organ-specific autoantibodies and the absence of the characteristic NMO-IgG antibody. Our case provides an opportunity to review the diagnostic criteria of NMO and its distinction from other autoimmune and demyelinating conditions. We report successful treatment with plasmapheresis and rituximab in NMO-IgG-negative relapsing disease.
Mangat
Pamela
P
Rheumatology Department, Royal Adelaide Hospital, Eleanor Harrald Building, North Terrace, Adelaide, SA 5000, Australia. pm897@hotmail.com
Ravindran
Janakan
J
Cleland
Les
L
Limaye
Vidya
V
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D017099:IgG Deficiency / Q000097:blood; D007155:Immunologic Factors / Q000627:therapeutic use; D009188:Myelitis, Transverse / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D012008:Recurrence; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab