Aquaporin-4-IgG Positive Neuromyelitis Optica Spectrum Disorder from Ethiopia: A Case Report

Abstract

BACKGROUND: Neuromyelitis Optica spectrum disorder is an inflammatory disorder affecting the central nervous system), most commonly attacking the spinal cord or optic nerves. Limited cases of neuromyelitis optica have been reported in east Africa. Based on my review, if published, this would be the second published case of Neuromyelitis Optica spectrum disorder and the first published case of seropositive Neuromyelitis Optica spectrum disorder reported from Ethiopia. It signifies the need to have a high index of suspicion to promptly identify and properly treat these patients.CASE PRESENTATION: I am reporting a 32 years old female patient from Addis Ababa, Ethiopia, who presented with recurrent lower limb weakness and impairment of right eye vision of two-year duration. She was diagnosed based on Neuromyelitis Optica spectrum disorder diagnostic criteria, by having transverse myelitis, optic neuritis, confirmed by MRI imaging and high level of aquaporin-4-antibodies. Symptoms improved after providing five days of Methylprednisolone followed by low doses of corticosteroids and Azathioprine. The patient is now fully functional except for the right eye vision impairment.CONCLUSION: The patient described here signifies a classic manifestation of Neuromylitis Optica disorder with aquaporin- 4-IgG occurring in Ethiopian woman. This case highlights the existence of Devic’s disease within our setting and the need toproperly diagnose this condition even in a resource-limited setting to avert disability.

A case report of Neuromyelitis Optica Spectrum Disorder (NMOSD) treatment in resource-limited setup: An Ethiopian Experience

“…Our patient meets the two core clinical criteria for the diagnosis of NMOSD, which include optic neuritis and longitudinally extensive transverse myelitis (10). The positive anti-aquaporin-4 antibodies and the absence of other competing diagnoses further support her condition's alignment with the international consensus criteria.…”

“…Based on our experience of treating this patient and local data from other documented cases, it is suggested that patients can be effectively treated with available therapies, leading to positive clinical and functional outcomes, unless newer immunosuppressive treatments targeting the underlying pathophysiology are available (19,20,21,22,23,24).…”