Case report: Hyponatremia is an initial presentation of Neuromyelitis optica spectrum disorder.

IF 1.5 4区医学 Q4 NEUROSCIENCES International Journal of Neuroscience Pub Date : 2024-11-01 Epub Date: 2023-11-30 DOI:10.1080/00207454.2023.2277666

Huaxing Meng, Jing Wang, Jiaqi Hou, Ruiqin Liu, Meini Zhang

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Abstract

Objective: Neuromyelitis optica spectrum disorders (NMOSD) is often misdiagnosed or delayed because of the complex and diverse clinical manifestations, especially the atypical initial presentation. Hyponatremia can be an infrequently isolated initial presentation of NMOSD and is associated with hypothalamus involvement. Awareness of this mechanism will help clinicians to identify NMOSD early, treat it in time and improve the prognosis.

Methods: We describe a 36-year-old woman who developed repeated hyponatremia and then experienced diplopia. Serum AQP4, MOG, MBP and GFAP antibody were detected, and NMOSD was finally diagnosed.

Results: She responded well to high-dose glucocorticoids. Sequential treatment with mycophenolate mofetil (MMF) was prescribed. Two-month follow-up revealed full recovery. So far, after 10 months, the patient still has no recurrence.

Conclusion: For young patients, repeated hyponatremia, with or without slight fever, and no evidence of obvious infection, brain magnetic resonance imaging (MRI) and serum AQP4/MOG antibody detection may be useful to determine whether there is a possibility of NMOSD.

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病例报告:低钠血症是视神经脊髓炎谱系障碍的最初表现。

目的:视神经脊髓炎频谱障碍(NMOSD)因其临床表现复杂多样，尤其是初始表现不典型，常被误诊或延误。低钠血症可能是NMOSD的罕见孤立的初始表现，与下丘脑受累有关。了解这一机制有助于临床医生及早发现NMOSD，及时治疗，改善预后。方法:我们描述了一位36岁的女性，她出现了反复低钠血症，然后经历了复视。检测血清AQP4、MOG、MBP和GFAP抗体，最终诊断为NMOSD。结果:大剂量糖皮质激素治疗效果良好。给予霉酚酸酯(MMF)序贯治疗。两个月的随访显示完全恢复。至今，10个月后，患者仍未复发。结论:对于反复低钠血症、伴或不伴轻微发热、无明显感染证据的年轻患者，脑磁共振成像(MRI)及血清AQP4/MOG抗体检测可用于判断是否存在NMOSD的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Neuroscience 医学-神经科学

CiteScore

5.10

自引率

0.00%

发文量

132

审稿时长

2 months

期刊介绍： The International Journal of Neuroscience publishes original research articles, reviews, brief scientific reports, case studies, letters to the editor and book reviews concerned with problems of the nervous system and related clinical studies, epidemiology, neuropathology, medical and surgical treatment options and outcomes, neuropsychology and other topics related to the research and care of persons with neurologic disorders. The focus of the journal is clinical and transitional research. Topics covered include but are not limited to: ALS, ataxia, autism, brain tumors, child neurology, demyelinating diseases, epilepsy, genetics, headache, lysosomal storage disease, mitochondrial dysfunction, movement disorders, multiple sclerosis, myopathy, neurodegenerative diseases, neuromuscular disorders, neuropharmacology, neuropsychiatry, neuropsychology, pain, sleep disorders, stroke, and other areas related to the neurosciences.