Neuromyelitis optica spectrum disorder co-existing with antiphospholipid syndrome: A case report.

Journal: Clinical case reports

Volume: 12

Issue: 5

Year of Publication: 

Affiliated Institutions:  Department of Internal Medicine The Benjamin Mkapa Hospital Dodoma Tanzania. Department of Internal Medicine, School of Medicine and Dentistry The University of Dodoma Dodoma Tanzania. Department of Psychiatry and Mental Health, School of Medicine The University of Dodoma Dodoma Tanzania.

Abstract summary 

Neuromyelitis optica spectrum disorder is an autoimmune disease, rarely presents with antiphospholipid syndrome. Diagnosis and management of NMOSD are challenging in the background of diverse presentations, especially in resource-limited settings.Neuromyelitis optica spectrum disorder (NMOSD) is a progressive demyelinating autoimmune condition resulting from the autoantibodies produced against aquaporin-4 (AQP-4) proteins which are widely distributed in astrocytes in the nervous system. In the setting of NMOSD, it is very crucial to consider other autoimmune diseases as differential diagnoses or co-occurrences due to the diversity of symptoms. NMOSD co-exists with other autoimmune diseases such as myasthenia gravis, thyroid disease, ankylosing spondylitis, pernicious anemia, thrombotic thrombocytopenic purpura, ulcerative colitis, and systemic lupus erythematosus. Few cases of antiphospholipid syndrome co-existing with NMOSD have been reported. In resource-limited settings, the published data are scarce, and therefore, autoimmune diseases are poorly studied. Therefore, late diagnosis and delayed treatment initiation pose long-term sequelae and hence poor prognosis. Here, we present a case of an African woman in her early 40s presenting with bilateral progressive loss of vision, transverse myelitis, extensive longitudinal hyperintense T2 cervical lesion, and AQP-4 autoantibody keeping with NMOSD. The co-existence of antiphospholipid syndrome, in this case, was supported by a history of recurrent pregnancy loss and positive antiphospholipid antibodies. This case underscores the importance of individualized-based medicine, especially in resource-limited settings.

Authors & Co-authors:  Edwin Gidion G Msagati Francis F Komanya Francisca F Alphonce Baraka B Meda John J Nyundo Azan A

Study Outcome 

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Statistics
Citations :  Wu Y, Zhong L, Geng J. Neuromyelitis optica spectrum disorder: pathogenesis, treatment, and experimental models. Mult Scler Relat Disord. 2019;27:412‐418.
Authors :  6
Identifiers
Doi : e8818
SSN : 2050-0904
Study Population
Male,Female
Mesh Terms
Other Terms
neuromyelitis optica spectrum disorder;optic neuritis;recurrent pregnancy losses;secondary antiphospholipid syndrome
Study Design
Study Approach
Country of Study
Publication Country
England