title: Neuromyelitis optica in patients with coexisting human immunodeficiency virus infections.
abstract: Two patients with known human immunodeficiency virus (HIV) infections and receiving antiretroviral treatment developed neuromyelitis optica (Devic's disease). One patient tested positive for serum aquaporin-4 immunoglobulin G antibodies. Both patients were treated with high dose pulsed intravenous methylprednisolone followed by standard sessions of plasma exchange both at the onset attack and during disease relapses. For maintenance therapy, one patient received rituximab infusions and the second patient received mycophenolate mofetil orally. Despite treatment, both patients are currently wheelchair-bound due to severe paraparesis. Neuromyelitis optica can occur in the course of HIV infection and poses an ongoing therapeutic challenge.
authors.affiliation: Department of Neurology, University of Texas Medical Branch at Galveston, USA. antmek13@yahoo.com
authors.forename: Anteneh M
authors.initials: AM
authors.lastname: Feyissa
authors.forename: Parbhdeep
authors.initials: P
authors.lastname: Singh
authors.forename: Robert G
authors.initials: RG
authors.lastname: Smith
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000503:physiopathology / Q000628:therapy / Q000821:virology*
keywords: Aquaporin-4 antibody; Devic’s disease; HIV; NMO; neuromyelitis optica; plasma exchange