Open AccessNeuromyelitis optica spectrum disorder in pediatrics. Case report
Author(s) -
Jhon Hadersson Camacho,
Sebastián Zuleta,
María Paula Alba,
Andrea Hernández,
Cárlos Navas
Publication year - 2019
Publication title -
case reports
Language(s) - English
Resource type - Journals
ISSN - 2462-8522
DOI - 10.15446/cr.v5n1.74943
Subject(s) - neuromyelitis optica , medicine , optic neuritis , spectrum disorder , demyelinating disorder , pediatrics , methylprednisolone , acute disseminated encephalomyelitis , rituximab , myelitis , presentation (obstetrics) , multiple sclerosis , dermatology , surgery , immunology , spinal cord , antibody , psychiatry
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.