Rituximab Therapy for Double Seronegative Neuromyelitis Optica Spectrum Disease

Area of Science:

• Neuroimmunology
• Neurology
• Clinical Case Study

Background:

• Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare CNS inflammatory disease.
• NMOSD can be seropositive for aquaporin-4 or anti-MOG antibodies, or seronegative.
• Double-seronegative NMOSD presents diagnostic and therapeutic challenges.

Observation:

• A 45-year-old female with a history of optic neuritis presented with progressive numbness and weakness.
• Diagnostic workup suggested NMOSD, but tests for AQP4 and MOG antibodies were negative.
• Initial treatment with methylprednisolone was insufficient.

Findings:

• The patient received two cycles of rituximab for presumed double-seronegative NMOSD.
• Rituximab, a B-cell depleting agent, targets CD20.
• Significant improvement in motor function and disability scores was observed post-rituximab treatment.

Implications:

• Rituximab may be a valuable therapeutic option for double-seronegative NMOSD.
• Early B-cell targeted therapy could alter NMOSD disease course.
• Further research into rituximab's efficacy in seronegative NMOSD is warranted.