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New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report.

Komolafe MA, Komolafe EO, Sunmonu TA, Olateju SO, Asaleye CM, Adesina OA, Badmus SA - J Med Case Rep (2008)

Bottom Line: She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome.We also highlight the unusual association with antiphospholipid syndrome.Physicians should screen such patients for autoimmune disorders.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. adeyoyin2001@yahoo.com.

ABSTRACT

Introduction: Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.

Case presentation: We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier.

Conclusion: Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.

No MeSH data available.


Related in: MedlinePlus

Cervical spine magnetic resonance imaging post-treatment with resolution of the previously noticed focus (Arrow B).
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Figure 2: Cervical spine magnetic resonance imaging post-treatment with resolution of the previously noticed focus (Arrow B).

Mentions: A repeat MRI was done a month after the initial one and showed resolution of the earlier noticed signal intensity at the spinomedullary junction (Figure 2). A final diagnosis of Devic's NMO syndrome was made and she was discharged after 5 weeks to be followed up in the outpatient clinic. She has been seen many times at the clinic and there has been sustained clinical and neurological improvement. However, she did not receive additional immunosuppressive therapy after completing the intravenous methylprednisolone, neither was there a repeat confirmatory test done for her antiphospholipid status. She was followed up in the clinic for 8 months after her discharge.


New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report.

Komolafe MA, Komolafe EO, Sunmonu TA, Olateju SO, Asaleye CM, Adesina OA, Badmus SA - J Med Case Rep (2008)

Cervical spine magnetic resonance imaging post-treatment with resolution of the previously noticed focus (Arrow B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2600793&req=5

Figure 2: Cervical spine magnetic resonance imaging post-treatment with resolution of the previously noticed focus (Arrow B).
Mentions: A repeat MRI was done a month after the initial one and showed resolution of the earlier noticed signal intensity at the spinomedullary junction (Figure 2). A final diagnosis of Devic's NMO syndrome was made and she was discharged after 5 weeks to be followed up in the outpatient clinic. She has been seen many times at the clinic and there has been sustained clinical and neurological improvement. However, she did not receive additional immunosuppressive therapy after completing the intravenous methylprednisolone, neither was there a repeat confirmatory test done for her antiphospholipid status. She was followed up in the clinic for 8 months after her discharge.

Bottom Line: She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome.We also highlight the unusual association with antiphospholipid syndrome.Physicians should screen such patients for autoimmune disorders.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. adeyoyin2001@yahoo.com.

ABSTRACT

Introduction: Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.

Case presentation: We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier.

Conclusion: Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.

No MeSH data available.


Related in: MedlinePlus