Otake Kosuke, Tagami Takashi, Kido Norihiro, Watanabe Akihiro, Sakamaki Masanori, Mochizuki Toru, Matsuda Kiyoshi
Department of Emergency and Critical Care Center Nippon Medical School Musashi-Kosugi Hospital Kanagawa Japan.
Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan.
Acute Med Surg. 2021 Jun 24;8(1):e655. doi: 10.1002/ams2.655. eCollection 2021 Jan-Dec.
Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system and is characterized by severe optic neuritis and transverse myelitis.
The patient was a 74-year-old man with pneumonia. On admission, he exhibited lower limb weakness and rapid respiratory deterioration in the form of tachypnea. Subsequently, he was transported to the Emergency Center of our hospital. High-signal lesions were observed from the cervical spinal cord to the thoracic spinal cord on T2-weighted spinal magnetic resonance images. Neuromyelitis optica was suspected, and the patient received steroid pulse therapy and immunoadsorption plasmapheresis. Serum samples obtained upon transfer were positive for anti-aquaporin-4 antibodies, which confirmed the diagnosis of neuromyelitis optica. Thereafter, the patient was transferred to a rehabilitation hospital.
Rapid respiratory failure in neuromyelitis optica is rare, and care is needed while treating these cases.
视神经脊髓炎是一种中枢神经系统炎性脱髓鞘疾病，其特征为严重的视神经炎和横贯性脊髓炎。
该患者为一名74岁男性，患有肺炎。入院时，他表现出下肢无力，并以呼吸急促的形式出现快速的呼吸功能恶化。随后，他被送往我院急诊科。在T2加权脊髓磁共振图像上，从颈髓到胸髓均观察到高信号病变。怀疑为视神经脊髓炎，患者接受了类固醇脉冲疗法和免疫吸附血浆置换。转诊时采集的血清样本抗水通道蛋白4抗体呈阳性，这证实了视神经脊髓炎的诊断。此后，患者被转至康复医院。
视神经脊髓炎患者出现快速呼吸衰竭较为罕见，治疗这些病例时需要谨慎。
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