title: Neuromyelitis optica in an adolescent after bone marrow transplantation.
abstract: BACKGROUND
  Central nervous system complications of bone marrow transplant are a common occurrence and the differential diagnosis is quite broad, including opportunistic infections, medications toxicities, graft versus host disease, and other autoimmune processes.
  
  
  METHODS
  We summarize previously reported cases of autoimmune myelitis in post-transplant patients and discuss a 17-year-old boy who presented with seronegative neuromyelitis optica after a bone marrow transplant for acute myeloid leukemia. Our patient had a marked improvement in symptoms after plasmapheresis.
  
  
  CONCLUSIONS
  Including our patient, there have been at least eight cases of post-transplant autoimmune myelitis presented in the literature, and at least three of these are suspicious for neuromyelitis optica. Several of these patients had poor outcomes with persistent symptoms after the myelitis. Autoimmune processes such as neuromyelitis optica should be carefully considered in patients after transplant as aggressive treatment like early plasmapheresis may improve outcomes.
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: Fiona.baumer@childrens.harvard.edu.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Baumer
authors.affiliation: Division of Hematology-Oncology, Boston Children's Hospital, Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
authors.forename: Junne
authors.initials: J
authors.lastname: Kamihara
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Gorman
mesh_terms: D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D009900:Optic Nerve / Q000473:pathology; D010956:Plasmapheresis; D013116:Spinal Cord / Q000473:pathology
keywords: acute myeloid leukemia; bone marrow transplantation; myelitis; neuromyelitis optica; optic neuritis; stem cell transplant