RT Journal Article
SR Electronic
T1 Recurrent Optic Neuritis and Perineuritis Followed by an Unexpected Discovery
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e200051
DO 10.1212/NXI.0000000000200051
VO 10
IS 1
A1 Daniela A. Pimentel Maldonado
A1 Robert Lisak
A1 Steven Galetta
A1 Laura Balcer
A1 Thomas Varkey
A1 Andrew Goodman
A1 Jennifer Graves
A1 Michael Racke
A1 Scott S. Zamvil
A1 Scott Newsome
A1 Elliot M. Frohman
A1 Teresa C. Frohman
YR 2023
UL http://nn.neurology.org/content/10/1/e200051.abstract
AB We describe a woman with a history of relapsing acute optic neuritis and perineuritis. Testing failed to confirm a specific diagnosis; hence, she was diagnosed with seronegative neuromyelitis optica spectrum disorder and treated with the immunotherapy rituximab, later in conjunction with mycophenolate mofetil. She achieved a durable remission for 9 years until she presented with paresthesia affecting her left fifth digit, right proximal thigh, and left foot, while also reporting a 25-pound weight loss over the prior 3 months. New imaging demonstrated a longitudinally extensive and enhancing optic nerve, in conjunction with multifocal enhancing lesions within the spinal cord, in a skip-like distribution. The differential diagnosis is discussed.ACE=angiotensin-converting enzyme; anti-AQP4=aquaporin-4 antibody; BNS=Bing-Neel syndrome; BTK=Bruton tyrosine kinase; CBA=cell-based assay; CLL=chronic lymphocytic lymphoma; ED=emergency department; MMF=mycophenolate mofetil; MOG=myelin oligodendrocyte glycoprotein; MOGAD=MOG antibody disease; NMOSD=neuromyelitis optica spectrum disorder; ON=optic neuritis; RBC=red blood cell; VA=visual acuity; WBC=white blood cell; WM=Waldenstrom macroglobulinemia