Work

Neuromyelitis optica associated with autoimmune myasthenia

Year: 2022

Type: article

Abstract: Neuromyelitis optica (NMO) and myasthenia gravis are well-recognised autoimmune diseases affecting the central nervous system and the neuromuscular junction, respectively. We report a case of 36-year-old female initially followed for generalised myasthenia with anti-acetylcholine receptor antibodies who developed a few years later NMO with positive anti- aquaporin-4 antibodies. Signs were rapidly progressive over 13 days with motor deficit of the lower limbs, urine retention, incoercible vomiting and hiccups. Cerebrospinal MRI showed an extensive intramedullary T2 hypersignal from the medulla oblongata to C7 while bilateral demyelinating optic nerve damage on visual evoked potentials and lymphocytosis in cerebrospinal fluid were also identified. The outcome was good with full recovery under corticosteroid therapy and azathioprine. The coincidence of these 2 diseases suggests that there is a subgroup of NMO patients with a common immunological mechanism with myasthenia.

Source: Neuroimmunology Reports

DOI: 10.1016/j.nerep.2022.100138