医学
横贯性脊髓炎
视神经脊髓炎
脊髓炎
美罗华
血浆置换术
急性横贯性脊髓炎
甲基强的松龙
多发性硬化
免疫学
病理
脊髓
内科学
淋巴瘤
抗体
精神科
作者
Anna Lafian,Tandis Mahani,Mehrnaz Hojjati,Taraneh Sarlati
出处
期刊:PubMed
日期:2023-10-09
标识
DOI:10.2174/0115733971261420230919110103
摘要
Transverse myelitis is considered one of the cardinal features of neuromyelitis optica spectrum disorder (NMOSD), an immune-mediated inflammatory condition of the CNS characterized by severe, immune-mediated demyelination and axonal damage predominantly targeting optic nerves and spinal cord. We describe a case in which a diagnosis of NMOSD was established, associated with West Nile Virus (WNV) infection.A healthy 18-year-old female presented with intractable hiccups and rapidly progressing paraparesis. MRI demonstrated T2 edema extending from the medulla to the conus, consistent with longitudinally extensive transverse myelitis. Serum and CSF Aquaporin-4 IgG (AQP4) were both positive with high titers. In conjunction with antiviral therapy, immunomodulatory treatment was initiated using pulse methylprednisolone, plasmapheresis and Rituximab. A month and a half after admission, the patient was fully ambulatory with no residual symptoms. On her rheumatology follow-up visit, West Nile Virus-specific IgM in CSF was found to be positive from the patient's initial presentation.We propose that West Nile Virus may have been the autoimmune trigger to the patient's development of NMOSD, highlighting the importance of evaluating viral triggers in autoimmune diseases.
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