Neuromyelitis optica spectrum disorder with AQP4‐IgG presenting as area postrema syndrome and progressing to myelitis: A rare case report

Abstract

Neuromyelitis optica spectrum disorders (NMOSDs) are rare immunological inflammatory disorders of the central nervous system (CNS) primarily involving the optic nerve, spinal cord, and brain. [1][2][3] It is more common, has younger age of onset, has higher brain/brainstem involvement in Africans and Asians than Caucasians, and is usually diagnosed in middle-aged females. 2,4 The majority of NMOSD patients have positive AQP4-Ab. 1 Diagnosis of NMOSD is based on International consensus diagnostic criteria, requiring certain clinical, laboratory, and imaging criteria to be met with the exclusion of differentials. 5,6 Acute attacks are primarily managed with intravenous corticosteroids. 1 In worsening cases, plasma exchange may be indicated. 1 Also, monoclonal antibodies, such as rituximab, eculizumab, tocilizumab, satralizumab, etc., can be used to modify the course of the disease. 7,8 Early diagnosis and intervention are crucial to prevent worsening and ensure optimum quality of life in these patients. 9,10 Herein, we present the case of a middle-aged Asian male with NMOSD with AQP4-IgG. | CASE REPORTA 52-year-old Asian male presented with multiple episodes of hiccups, vomiting, decreased bladder sensation,

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

“…The 2015 revised international consensus criteria base the diagnosis of NMOSD on the presence of core clinical characteristics and serum AQP‐4 autoantibodies 11,13–15 . Besides, other alternative diagnoses such as multiple sclerosis, Gullaine–barre syndrome, and myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) should be excluded.…”

“…The 2015 revised international consensus criteria base the diagnosis of NMOSD on the presence of core clinical characteristics and serum AQP‐4 autoantibodies. 11 , 13 , 14 , 15 Besides, other alternative diagnoses such as multiple sclerosis, Gullaine–barre syndrome, and myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) should be excluded. The diversity of presentations and scarcity of published data on NMOSD especially from resource‐limited settings poses diagnostic and management challenges.…”