Abstract
Neuromyelitis optica (NMO), characterised by longitudinally extensive transverse myelitis (LETM), was previously thought to be a variant of multiple sclerosis. Transverse myelitis may be a manifestation of autoimmune connective tissue diseases and NMO is now recognised to be a humorally mediated autoimmune disease. We present a case of NMO associated with non-organ-specific autoantibodies and the absence of the characteristic NMO-IgG antibody. Our case provides an opportunity to review the diagnostic criteria of NMO and its distinction from other autoimmune and demyelinating conditions. We report successful treatment with plasmapheresis and rituximab in NMO-IgG-negative relapsing disease.
Similar content being viewed by others
References
Jacob A, Matiello M, Wingerchuk D et al (2007) Neuromyelitis optica: changing concepts. J Neuroimmunol 187:126–138
Wingerchuk DM, Lennon VA, Pittock SJ et al (2006) Revised diagnostic criteria for neuromyelitis optica (Devic’s syndrome). Neurology 53:1107–1114
McDonald WI, Compston A, Edan G et al (2001) Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 50:121–127
Wingerchuk DM, Hogancamp WF, O’Brien PC et al (1999) The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 53:1107–1114
Lennon VA, Wingerchuk DM, Kryzer TJ et al (2004) A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364:2106–2112
Weinshenker BG, Wingerchuk DM, Vukusic S et al (2006) Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis. Ann Neurol 59:566–569
Hosseini H, Brugieres P, Degos JD et al (2003) Neuromyelitis after a spinal anaesthesia with bupivacaine. Mult Scler 9(5):526–528
Misu T, Fujihara K, Nakashima I et al (2005) Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica. Neurology 65:1479–1482
Pittock SJ, Lennon VA et al (2008) Neuromyelitis optica and non organ specific autoimmunity. Arch Neurol 65(1):78–83
Weinshenker BG, O’Brien PC, Petterson TM (1999) A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol 46:878–886
Mandler RN, Ahmed W, Dencoff JE et al (1998) Devic’s neuromyelitis optica: a prospective study of seven patients treated with prednisolone and azathioprine. Neurology 51:1219–1220
Cree BA, Lamb S, Morgan K et al (2005) An open label study of the effects of rituximab in neuromyelitis optica. Neurology 64:1270–1272
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mangat, P., Ravindran, J., Cleland, L. et al. A case of longitudinally extensive transverse myelitis (LETM): neuromyelitis optica. Clin Rheumatol 27 (Suppl 2), 67–69 (2008). https://doi.org/10.1007/s10067-008-0936-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-008-0936-7