A case of area postrema variant of neuromyelitis optica spectrum disorder following SARS-CoV-2 infection

被引:24
作者
Ghosh, Ritwik [1 ]
De, Kaustav [1 ]
Roy, Devlina [1 ]
Mandal, Arpan [1 ]
Biswas, Subrata [1 ]
Biswas, Subhrajyoti [1 ]
Sengupta, Swagatam [1 ]
Naga, Dinabandhu [1 ]
Ghosh, Mrinalkanti [2 ]
Benito-Leon, Julian [3 ,4 ,5 ]
机构
[1] Burdwan Med Coll, Dept Gen Med, Burdwan, W Bengal, India
[2] Burdwan Med Coll, Dept Radiol, Burdwan, W Bengal, India
[3] Univ Hosp 12 Octubre, Dept Neurol, Madrid, Spain
[4] Ctr Invest Biomed Red Enfermedades Neurodegenerat, Madrid, Spain
[5] Univ Complutense Madrid, Dept Med, Madrid, Spain
关键词
Neuromyelitis optica; NMOSD; COVID-19; SARS-CoV-2; Immune-mediated; Longitudinally extensive transverse myelitis; ANTIBODY; MYELITIS;
D O I
10.1016/j.jneuroim.2020.577439
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Neuromyelitis optica spectrum disorder (NMOSD) is a disabling autoimmune astrocytopathic channelopathy, characterized by the presence of pathogenic antibodies to aquaporin-4 (AQP-4) water channels. Several viral infections including HIV, influenza virus, varicella zoster virus, and Epstein Barr virus, among others, have been alleged to trigger NMOSD in both immunocompetent and immunocompromised individuals. Neurological manifestations of coronavirus infectious disease of 2019 (COVID-19) have been ever evolving and the spectrum of neuraxial involvement is broadening. Albeit it may affect any area of the neural axis, the involvement of the spinal cord is rare compared to that of the brain and of the peripheral nervous system. Cases with acute longitudinally extensive transverse myelitis (LETM) have been recently reported in SARS-CoV-2 infection but did not fulfill the international consensus diagnostic criteria for NMOSD. AQP-4-antibody-seropositive NMOSD following SARS-CoV-2 infection had not yet been reported. We herein report a novel case of a previously healthy man who presented with a clinical picture of bouts of vomiting and hiccoughs (area postrema syndrome), which rapidly evolved to acute LETM, all following SARS-CoV-2 infection. He was finally diagnosed to be a case of seropositive NMOSD which presented as area postrema syndrome. The response to immunomodulatory drugs was excellent.
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页数:4
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