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一名年轻男性患者的视神经脊髓炎:病例报告及文献综述

Neuromyelitis optica in a young male patient: a case report and literature review.

作者信息

Ayen Addisu Assfaw, Ewunetu Mulugeta Beyadgie, Yismaw Tewodros Ayenew, Damtew Azmeraw Birhan, Firew Nibret Gedamu, Engedaw Hailemariam Awoke, Baye Mebratu Libanos, Asfaw Tsion Wolanewos, Belay Bekalu Mekonen, Kassa Belayneh Dessie

机构信息

Department of Internal Medicine, Debre Tabor University, Debre Tabor, Ethiopia.

Department of Internal Medicine, Neurology Unit, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

Ann Med Surg (Lond). 2025 Apr 25;87(6):3949-3955. doi: 10.1097/MS9.0000000000003328. eCollection 2025 Jun.

Abstract

INTRODUCTION AND IMPORTANCE

Neuromyelitis optica (NMO) is a rare immune-mediated neurologic disease with female predominance with a 9:1 ratio, with an average age of 40 years. It is uncommon in males and young patients.

CASE PRESENTATION

A 23-year-old male from Ethiopia presented with progressive leg weakness, which escalated to include other symptoms like cough, shortness of breath, and vision problems. Neurological exam revealed specific deficits including leg paralysis, arm weakness, and sensory loss up to the mid-chest. Based on these symptoms and magnetic resonance imaging (MRI), he was diagnosed with neuromyelitis optica spectrum disorder (NMOSD), treated successfully with steroids and azathioprine, and improved.

CASE DISCUSSION

NMO is rare autoimmune central nervous system disease with severe symptoms (spinal cord, optic nerve, brainstem). NMO is usually common in females (9:1) around age 40. NMOSD is rare (low incidence/prevalence), but risk varies: higher mortality/risk in African and Asian populations. The diagnosis of NMOSD can be diagnosed based on the 2015 international consensus diagnostic criteria.

CONCLUSION

Even though Neuromyelitis Optica is a rare immune-mediated neurologic disease, and even more uncommon in young male individuals, it can occur and be diagnosed by clinical criteria with or without AQP4-antibodies plus consistent MRI findings.

摘要

引言与重要性

视神经脊髓炎(NMO)是一种罕见的免疫介导性神经系统疾病,女性居多,男女比例为9:1,平均发病年龄为40岁。在男性和年轻患者中并不常见。

病例介绍

一名来自埃塞俄比亚的23岁男性,出现进行性腿部无力,并逐渐发展为伴有咳嗽、呼吸急促和视力问题等其他症状。神经系统检查发现了特定的功能缺损,包括腿部瘫痪、手臂无力以及胸部中部以下感觉丧失。基于这些症状和磁共振成像(MRI)检查结果,他被诊断为视神经脊髓炎谱系障碍(NMOSD),接受了类固醇和硫唑嘌呤治疗并成功康复。

病例讨论

NMO是一种罕见的自身免疫性中枢神经系统疾病,症状严重(累及脊髓、视神经、脑干)。NMO通常在40岁左右的女性中较为常见(男女比例9:1)。NMOSD较为罕见(发病率/患病率低),但风险因人群而异:在非洲和亚洲人群中死亡率/风险更高。NMOSD可根据2015年国际共识诊断标准进行诊断。

结论

尽管视神经脊髓炎是一种罕见的免疫介导性神经系统疾病,在年轻男性个体中更为罕见,但它仍可能发生,可通过临床标准进行诊断,无论是否存在水通道蛋白4抗体,同时结合一致的MRI表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1039/12140719/b8834d64911a/ms9-87-3949-g001.jpg

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