Neuromyelitis optica (NMO)

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Previous well with rapidly evolving lower upper motor neuron weakness and signs. Bladder dysfunction. Brain MRI normal.

Patient Data

Age: 40 years
Gender: Female
mri

Involving the cervicothoracic cord is a longitudinally extensive spinal cord lesion (LESCL) of an abnormal T2 signal with cord swelling. The central cord is involved. No hemorrhage. 

 

Case Discussion

The patient went on to have extensive diagnostic work-up. 

  • Neuromyelitis Optica antibodies: POSITIVE
  • Rheumatoid Antibodies
    • Rheumatoid Factor <20 IU/mL (normal range: <20)
  • Antinuclear Antibodies
    • Antinuclear antibodies: POSITIVE
    • Speckled Titer: 40
    • Speck/Nuclr Titer: 640
  • Extractable Nuclear Antigens
    • Ext. Nuclear Ags Positive
    • Anti - Sm: Negative
    • Anti - RNP: Negative
    • Anti - Ro: POSITIVE
    • Anti - La: POSITIVE
    • Anti - Topo1: Negative
    • Anti - Jo1: Negative
  • Double Stranded DNA Antibodies
    • dsDNA 0.7  2.7 IU/mL (normal range: 0-4.0)

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