Shrateh Oadi N, Jobran Afnan W M, Khaled Zaina, Zaid Momen A, Dallashi Ahmad A
Faculty of Medicine, Al-Quds University, Jerusalem.
Department of Internal Medicine, Palestinian Medical Complex, Ramallah, Palestine.
Ann Med Surg (Lond). 2023 May 24;85(6):3145-3148. doi: 10.1097/MS9.0000000000000887. eCollection 2023 Jun.
Central nervous system (CNS) inflammatory demyelinating disease known as neuromyelitis optica spectrum disorder (NMOSD) is characterized by recurrent inflammatory events that primarily affect the optic nerves and spinal cord; it may also affect the hypothalamus, area postrema, and periaqueductal gray matter. The NMOSD-specific aquaporin-4 antibody (AQP4-IgG) is available. Myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) have recently been discovered in a group of patients who do not have AQP4-IgG.
A 29-year-old female presented to the hospital with the complaint of blurry vision in her right eye and left eye ptosis for 2 days. Two months ago, the patient had a history of generalized fatigue with continuous documented fever with an average of 38.5°C, which was relieved by acetaminophen and ibuprofen. She also complained of continuous hiccups that increased at night and interfered with her sleep pattern and breathing; they lasted for 3 weeks and disappeared suddenly. She had also developed episodes of vomiting and could not tolerate food intake due to which she lost 6 kg within 3 weeks. She was later diagnosed with neuromyelitis optica (NMO) using radiological neuroimaging.
Early and correct diagnosis, followed by urgent treatment for acute exacerbations and the prevention of further relapses, are essential for treating NMO spectrum illnesses since they entail significant morbidity and, occasionally, fatality.
The patient mentioned here represents a typical example of NMO disease. This case emphasizes the presence of this disease in our environment and the importance of accurately diagnosing this ailment, even in a context with minimal resources, to prevent disability.
中枢神经系统(CNS)炎性脱髓鞘疾病,即视神经脊髓炎谱系障碍(NMOSD),其特征为反复发生的炎症事件,主要影响视神经和脊髓;它也可能影响下丘脑、最后区和导水管周围灰质。可检测到NMOSD特异性水通道蛋白4抗体(AQP4-IgG)。最近在一组没有AQP4-IgG的患者中发现了髓鞘少突胶质细胞糖蛋白抗体(MOG-IgG)。
一名29岁女性因右眼视物模糊和左眼上睑下垂2天入院。两个月前,患者有全身乏力病史,持续记录发热,平均体温38.5°C,对乙酰氨基酚和布洛芬可缓解。她还抱怨持续打嗝,夜间加重,干扰睡眠模式和呼吸;持续3周后突然消失。她还出现呕吐发作,无法耐受食物摄入,因此在3周内体重减轻了6千克。后来通过放射学神经影像学检查诊断为视神经脊髓炎(NMO)。
对于治疗NMO谱系疾病,早期正确诊断,随后对急性加重进行紧急治疗并预防进一步复发至关重要,因为这些疾病会导致严重的发病率,偶尔还会导致死亡。
这里提到的患者是NMO疾病的典型例子。该病例强调了这种疾病在我们所处环境中的存在,以及即使在资源有限的情况下准确诊断这种疾病以预防残疾的重要性。