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Neuromyelitis optica spectrum disorder in a patient with systemic lupus erythematosus and anti-phospholipid antibody syndrome

Neuroimmunology Unit, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA, lahar_mehta{at}urmc.rochester.edu

Melissa K Samuelsson

Neuroimmunology Unit, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

Anatole K Kleiner

Allergy, Immunology and Rheumatology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA

Andrew D Goodman

Neuroimmunology Unit, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

Jennifer H Anolik

Allergy, Immunology and Rheumatology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA

R John Looney

Allergy, Immunology and Rheumatology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA

Steven R Schwid

Neuroimmunology Unit, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

Neuromyelitis optica (NMO) is a demyelinating disease of the central nervous system characterized by severe episodes of optic nerve and spinal cord inflammation. NMO-IgG (anti-aquaporin-4) has been recently described as a sensitive and specific marker for NMO. As there have been prior published reports of an association between NMO and systemic autoimmune diseases, the prognostic value of the antibody test in these cases is uncertain. We describe a 47-year old woman with recurrent transverse myelitis and a long-standing history of systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APLS). While she did not have a history of optic neuritis, serological testing for the NMO-IgG was positive when she was admitted for her second episode of transverse myelitis. Testing for the NMO-IgG in cases of isolated or recurrent transverse myelitis attributed to current SLE and APLS may help clarify the diagnosis of a distinct disease process likely to cause recurrent and severe disability, warranting more aggressive immunotherapy. Multiple Sclerosis 2008; 14: 425—427. http://msj.sagepub.com

Key Words: anti-phospholpid antibody syndrome • neuromyelitis optica • NMO-IgG • systemic lupus erythematosus

This version was published on April 1, 2008

Multiple Sclerosis, Vol. 14, No. 3, 425-427 (2008)
DOI: 10.1177/1352458507084107


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