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Neurological Sciences

, Volume 36, Issue 12, pp 2301–2302 | Cite as

Rituximab as a first-line treatment in pediatric neuromyelitis optica spectrum disorder

  • Giorgia Olivieri
  • Viviana NocitiEmail author
  • Raffaele Iorio
  • Maria Chiara Stefanini
  • Francesco Antonio Losavio
  • Massimiliano Mirabella
  • Paolo Mariotti
Letter to the Editor

Introduction

Neuromyelitis optica (NMO) is an autoimmune astrocytopathy that involves the optic nerve and the spinal cord. The detection of immunoglobulin-G (IgG) autoantibodies specific for the aquaporin-4 (AQP4) water channel unifies a spectrum of neurological manifestation (NMO spectrum disorders, NMOSD) that includes NMO and its partial forms distinguishing them from other inflammatory diseases of the central nervous system (CNS) [1]. Compelling evidence exists that AQP4-IgG has pathogenic potential.

Moreover, the detection of AQP4-IgG predicts optic neuritis and LETM relapses with cumulative attack-related neurological disability [2].

Here we describe the case of a young girl with a severe onset NMOSD, treated with Rituximab (MabThera©) as first-line therapy.

Case report

A 9-year-old girl was admitted to our Pediatric Intensive Care Unit for the onset of severe and increasing loss of strength, limb and joint pain, progressively increasing axial rigidity, neck stiffness and urinary...

Keywords

Pediatric NMOSD Aquaporin-4 Rituximab First-line therapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

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    Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, Nakashima I, Weinshenker BG (2004) A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364:2106–2112CrossRefPubMedGoogle Scholar
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    Iorio R, Damato V, Mirabella M, Evoli A, Marti A, Plantone D, Frisullo G, Batocchi AP (2013) Distinctive clinical and neuroimaging characteristics of longitudinally extensive transverse myelitis associated with aquaporin-4 autoantibodies. J Neurol 260:2396–2402CrossRefPubMedGoogle Scholar
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    Dale RC, Brilot F, Duffy LV et al (2014) Utility and safety of rituximab in pediatric autoimmune and inflammatory CNS disease. Neurology 83:142–150PubMedCentralCrossRefPubMedGoogle Scholar
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Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Giorgia Olivieri
    • 1
  • Viviana Nociti
    • 2
    • 3
    Email author
  • Raffaele Iorio
    • 2
  • Maria Chiara Stefanini
    • 1
  • Francesco Antonio Losavio
    • 2
  • Massimiliano Mirabella
    • 2
  • Paolo Mariotti
    • 1
  1. 1.Unit of Child NeuropsychiatryCatholic UniversityRomeItaly
  2. 2.Department of Geriatrics, Neurosciences and Orthopedics, Institute of NeurologyCatholic UniversityRomeItaly
  3. 3.Don C. Gnocchi Foundation OnlusMilanItaly

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