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First published on January 21, 2008, doi:10.1177/1352458507084107

Multiple Sclerosis 2008;14:425.

A more recent version of this article appeared on April 1, 2008
 This version was published on January 31, 2008

Article

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

L.R. Mehta1*, M.K. Samuelsson2, Anatole K. Kleiner3, Andrew D. Goodman2, J.H. Anolik3, Richard John Looney3, and Steven R. Schwid2

1 1Neuroimmunology Unit, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
2 Neuroimmunology Unit, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
3 Allergy, Immunology and Rheumatology Unit, Department of Medicine, University of Rochester Medical Center,Rochester, NY, USA

* To whom correspondence should be addressed.


  Abstract

Neuromyelitis optica (NMO) is a demyelinating disease of the central nervous system characterizedby severe episodes of optic nerve and spinal cord inflammation. NMO-IgG (anti-aquaporin-4) hasbeen recently described as a sensitive and specific marker for NMO. As there have been priorpublished reports of an association between NMO and systemic autoimmune diseases, the prognosticvalue of the antibody test in these cases is uncertain. We describe a 47-year old woman with recurrenttransverse myelitis and a long-standing history of systemic lupus erythematosus (SLE) and antiphospholipidantibody syndrome (APLS). While she did not have a history of optic neuritis, serologicaltesting for the NMO-IgG was positive when she was admitted for her second episode of transversemyelitis. Testing for the NMO-IgG in cases of isolated or recurrent transverse myelitis attributed tocurrent SLE and APLS may help clarify the diagnosis of a distinct disease process likely to cause recurrentand severe disability, warranting more aggressive immunotherapy.

Key Words: anti-phospholpid antibody syndrome; neuromyelitis optica; NMO-IgG; systemic lupuserythematosus


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