Neuromyelitis optica spectrum disorder in pediatrics. Case report
Introduction: Neuromyelitis optica is an inflammatory disorder of the central nervous system that accounts for 5% of demyelinating diseases in pediatrics. Its clinical presentation is variable and associated to the involved area of the central nervous system. Case presentation: This is the case of...
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Universidad Nacional de Colombia
2019-01-01
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| Series: | Case Reports |
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| Online Access: | https://revistas.unal.edu.co/index.php/care/article/view/74943 |
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| author | Jhon Camacho Sebastian Zuleta Maria Paula Alba Andrea Hernandez Carlos Navas |
| author_facet | Jhon Camacho Sebastian Zuleta Maria Paula Alba Andrea Hernandez Carlos Navas |
| author_sort | Jhon Camacho |
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Introduction: Neuromyelitis optica is an inflammatory disorder of the central nervous system that accounts for 5% of demyelinating diseases in pediatrics. Its clinical presentation is variable and associated to the involved area of the central nervous system.
Case presentation: This is the case of a 15-year-old patient who consulted several times for nonspecific neurological symptoms. During his last visit to the Clínica Universitaria Colombia in Bogotá, he presented with bilateral optic neuritis, associated with frontal and parietal headache. Immunophenotyping studies were carried out, reporting positive IgG anti-aquaporin 4 antibodies (anti-AQP4 antibody), thus leading to a diagnosis of seropositive neuromyelitis optica spectrum disorder (NMOSD). Management with methylprednisolone pulses was initiated with subsequent outpatient management with rituximab that allowed stabilizing the disease.
Discussion: This is an interesting case due to its insidious and uncertain onset in a pediatric patient. It was possible to evaluate clinical and diagnostic differences in relation to its presentation in adults. NMOSD mediated by anti-AQP4 is rare; brain and bone marrow MRI are essential for diagnosis. The treatment of choice for acute conditions consists of high doses of methylprednisolone.
Conclusion: This disorder may result in irreversible neurological damage; for this reason, high suspicion is required for early diagnosis and timely treatment.
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| format | Article |
| id | doaj-art-7e3f5f712d6c4e58ac1f0a72d61b21c7 |
| institution | Kabale University |
| issn | 2462-8522 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Universidad Nacional de Colombia |
| record_format | Article |
| series | Case Reports |
| spelling | doaj-art-7e3f5f712d6c4e58ac1f0a72d61b21c72024-11-26T23:59:24ZengUniversidad Nacional de ColombiaCase Reports2462-85222019-01-015110.15446/cr.v5n1.7494350173Neuromyelitis optica spectrum disorder in pediatrics. Case reportJhon Camachohttps://orcid.org/0000-0003-0898-9223Sebastian Zuletahttps://orcid.org/0000-0001-6122-4946Maria Paula Albahttps://orcid.org/0000-0002-9009-7509Andrea Hernandezhttps://orcid.org/0000-0002-7714-0189Carlos Navashttps://orcid.org/0000-0002-0472-3930 Introduction: Neuromyelitis optica is an inflammatory disorder of the central nervous system that accounts for 5% of demyelinating diseases in pediatrics. Its clinical presentation is variable and associated to the involved area of the central nervous system. Case presentation: This is the case of a 15-year-old patient who consulted several times for nonspecific neurological symptoms. During his last visit to the Clínica Universitaria Colombia in Bogotá, he presented with bilateral optic neuritis, associated with frontal and parietal headache. Immunophenotyping studies were carried out, reporting positive IgG anti-aquaporin 4 antibodies (anti-AQP4 antibody), thus leading to a diagnosis of seropositive neuromyelitis optica spectrum disorder (NMOSD). Management with methylprednisolone pulses was initiated with subsequent outpatient management with rituximab that allowed stabilizing the disease. Discussion: This is an interesting case due to its insidious and uncertain onset in a pediatric patient. It was possible to evaluate clinical and diagnostic differences in relation to its presentation in adults. NMOSD mediated by anti-AQP4 is rare; brain and bone marrow MRI are essential for diagnosis. The treatment of choice for acute conditions consists of high doses of methylprednisolone. Conclusion: This disorder may result in irreversible neurological damage; for this reason, high suspicion is required for early diagnosis and timely treatment. https://revistas.unal.edu.co/index.php/care/article/view/74943Neuromyelitis OpticaOptic NeuritisAntibodiesAquaporin 4MethylprednisoloneRituximab. |
| spellingShingle | Jhon Camacho Sebastian Zuleta Maria Paula Alba Andrea Hernandez Carlos Navas Neuromyelitis optica spectrum disorder in pediatrics. Case report Case Reports Neuromyelitis Optica Optic Neuritis Antibodies Aquaporin 4 Methylprednisolone Rituximab. |
| title | Neuromyelitis optica spectrum disorder in pediatrics. Case report |
| title_full | Neuromyelitis optica spectrum disorder in pediatrics. Case report |
| title_fullStr | Neuromyelitis optica spectrum disorder in pediatrics. Case report |
| title_full_unstemmed | Neuromyelitis optica spectrum disorder in pediatrics. Case report |
| title_short | Neuromyelitis optica spectrum disorder in pediatrics. Case report |
| title_sort | neuromyelitis optica spectrum disorder in pediatrics case report |
| topic | Neuromyelitis Optica Optic Neuritis Antibodies Aquaporin 4 Methylprednisolone Rituximab. |
| url | https://revistas.unal.edu.co/index.php/care/article/view/74943 |
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