[European treatment recommendation of neuromyelitis optica spectrum disorders: critical remarks and case discussion].
Neuromyelitis optica is a demyelinating disease of the central nervous system mediated by antibodies against the waterchannel aquaporin4 (AQP4). In a number of cases the clinical manifestation is spatially limited. Such events of separate longitudinally extensive transverse myelitis (LETM) or relapsing/bilateral optic neuritis (RION/BON) are defined as NMO spectrum diseases. The diagnosis is further challenged by anti-AQP4 seronegative cases. While chronic immunosuppressive therapy should be introduced in definitive NMO, treatment strategy of the NMO spectrum is less defined. Recent EFNS guidelines recommend chronic immunosuppressive treatment of NMO spectrum diseases depending on the clinical course even in AQP4-seropositive cases. Presenting a case with relapsing optic neuritis, here we emphasize the importance of early immunosuppressive therapy in all seropositive NMO spectrum diseases regardless of relapse severity, in order to prevent an upcoming devastating relapse, i.e. NMO conversion.
Pécsi Tudományegyetem, Neurológiai Klinika, Pécs.
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D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D004334:Drug Administration Schedule; D005060:Europe; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009471:Neuromyelitis Optica / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control*; D055502:Secondary Prevention; D013997:Time Factors
D051401:Aquaporin 4; D001323:Autoantibodies; D007166:Immunosuppressive Agents