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Neuromyelitis optica spectrum disorder mimicking multiple sclerosis
Lucas C van Rooij1, Mike P Wattjes2, Brigit A de Jong3
1Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands.
Background:
MS is a demyelinating CNS disease and has distinct clinical and radiological features. Neuromyelitis optica spectrum disorder (NMOSD) is an antibody related auto-immune disease known for invalidating episodes of myelitis and optic neuritis.
Objective:
Reporting the case of a 29-year old woman with a disease course typical for relapsing remitting MS with consistent radiological and spinal fluid findings, who developed longitudinally extensive transverse myelitis (LETM) with positive aquaporin 4 antibodies, fulfilling the diagnostic criteria for NMOSD.
Methods:
Case report.
Results:
LETM is not consistent with MS. Consider NMOSD even in patients with typical MS and check for aquaporin-4 antibodies, with important treatment consequences.
Insights
Neuromyelitis optica spectrum disorder (NMOSD) can mimic multiple sclerosis (MS) even with typical MS features. Early aquaporin-4 antibody testing is crucial for accurate NMOSD diagnosis and appropriate treatment.
Area of Science:
- Neurology
- Immunology
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a central nervous system demyelinating disease with characteristic clinical and radiological presentations.
- Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune condition triggered by antibodies, often causing severe myelitis and optic neuritis.
Observation:
- A 29-year-old woman presented with a clinical and radiological profile typical of relapsing-remitting MS.
- She developed longitudinally extensive transverse myelitis (LETM), a condition not typically associated with MS.
Findings:
- The patient tested positive for aquaporin-4 antibodies.
- These findings fulfilled the diagnostic criteria for NMOSD, despite the initial presentation resembling MS.
Implications:
- LETM in a patient with MS-like symptoms warrants consideration of NMOSD.
- Testing for aquaporin-4 antibodies is critical for differentiating NMOSD from MS, impacting treatment strategies.
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