{"title":"极晚期神经脊髓炎同时伴有双侧视神经炎和脊髓炎：病例报告","authors":"S Gandelman , S Parauda , C Dohle","doi":"10.1016/j.nerep.2024.100227","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>New-onset Neuromyelitis Optica Spectrum Disorder (NMOSD) has rarely been reported in adults over age 70. We describe a severe presentation in a 77-year-old female.</p></div><div><h3>Case</h3><p>The patient presented with left arm numbness, followed by left leg numbness and bilateral optic neuritis. Neuroimaging showed a C2-T1 lesion with C4-C7 holocord enhancement, and bilateral optic nerve enhancement extending to the optic chiasm. Serum testing detected anti-aquaporin-4 antibodies. She was left with dyschromatopsia, myelopathy, and ambulatory dysfunction. She had a history notable for rheumatoid arthritis, treated with rituximab, which had been discontinued six years prior to presentation.</p></div><div><h3>Discussion</h3><p>Very-late-onset NMOSD encompasses a unique cohort of patients with significant immunogenicity despite immunosenescence. Limited data suggest diagnostic delays, severe morbidity, and decreased utilization of disease-modifying therapies.</p></div>","PeriodicalId":100950,"journal":{"name":"Neuroimmunology Reports","volume":"6 ","pages":"Article 100227"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667257X24000287/pdfft?md5=911d5b73fdd8fbd05a4f3ee1c3b475a6&pid=1-s2.0-S2667257X24000287-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Very late-onset neuromyelitis optica presenting with simultaneous bilateral optic neuritis and myelitis: A case report\",\"authors\":\"S Gandelman , S Parauda , C Dohle\",\"doi\":\"10.1016/j.nerep.2024.100227\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>New-onset Neuromyelitis Optica Spectrum Disorder (NMOSD) has rarely been reported in adults over age 70. We describe a severe presentation in a 77-year-old female.</p></div><div><h3>Case</h3><p>The patient presented with left arm numbness, followed by left leg numbness and bilateral optic neuritis. Neuroimaging showed a C2-T1 lesion with C4-C7 holocord enhancement, and bilateral optic nerve enhancement extending to the optic chiasm. Serum testing detected anti-aquaporin-4 antibodies. She was left with dyschromatopsia, myelopathy, and ambulatory dysfunction. She had a history notable for rheumatoid arthritis, treated with rituximab, which had been discontinued six years prior to presentation.</p></div><div><h3>Discussion</h3><p>Very-late-onset NMOSD encompasses a unique cohort of patients with significant immunogenicity despite immunosenescence. Limited data suggest diagnostic delays, severe morbidity, and decreased utilization of disease-modifying therapies.</p></div>\",\"PeriodicalId\":100950,\"journal\":{\"name\":\"Neuroimmunology Reports\",\"volume\":\"6 \",\"pages\":\"Article 100227\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2667257X24000287/pdfft?md5=911d5b73fdd8fbd05a4f3ee1c3b475a6&pid=1-s2.0-S2667257X24000287-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroimmunology Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667257X24000287\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroimmunology Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667257X24000287","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Very late-onset neuromyelitis optica presenting with simultaneous bilateral optic neuritis and myelitis: A case report
Background
New-onset Neuromyelitis Optica Spectrum Disorder (NMOSD) has rarely been reported in adults over age 70. We describe a severe presentation in a 77-year-old female.
Case
The patient presented with left arm numbness, followed by left leg numbness and bilateral optic neuritis. Neuroimaging showed a C2-T1 lesion with C4-C7 holocord enhancement, and bilateral optic nerve enhancement extending to the optic chiasm. Serum testing detected anti-aquaporin-4 antibodies. She was left with dyschromatopsia, myelopathy, and ambulatory dysfunction. She had a history notable for rheumatoid arthritis, treated with rituximab, which had been discontinued six years prior to presentation.
Discussion
Very-late-onset NMOSD encompasses a unique cohort of patients with significant immunogenicity despite immunosenescence. Limited data suggest diagnostic delays, severe morbidity, and decreased utilization of disease-modifying therapies.
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