Seropositive Neuromyelitis Optica: A Pediatric Case Report and 6-Year Follow-Up

Abstract

BACKGROUND: Neuromyelitis optica is an autoimmune demyelinating disorder of the central nervous system. Although it has some features in common with multiple sclerosis, it has different clinical features, prognosis, and treatment. We describe a boy with seropositive neuromyelitis optica and his 6-year follow-up. PATIENT: A boy aged 5 years 8 months presented with relapsing optic neuritis, short segment transverse myelitis, and brain involvement. He met the diagnostic criteria for multiple sclerosis fulfilling the McDonald 2010 criteria; however, neuromyelitis optica immunoglobulin-G was detected, and the patient was diagnosed with neuromyelitis optica. He had frequent relapses until immunosuppressive treatment with azathioprine and low-dose prednisone was started. After he was asymptomatic for 2.5 years, prednisone was withdrawn, but he had a new attack soon after withdrawal of the steroid. CONCLUSIONS: It is important to differentiate neuromyelitis optica from multiple sclerosis because early immunosuppressive treatment prevents further disability, and longer periods of immunosuppressive treatment should be planned to prevent relapses. (C) 2013 Elsevier Inc. All rights reserved.