Double seropositive neuromyelitis optica associated with COVID-19: A case report.

Autor:	Antonescu Ghelmez D; Department of Neurology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.; Department of Neurology, National Institute of Neurology and Neurovascular Diseases Bucharest, Bucharest, Romania., Moraru A; Department of Neurology, National Institute of Neurology and Neurovascular Diseases Bucharest, Bucharest, Romania., Antonescu F; Department of Neurology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.; Department of Neurology, National Institute of Neurology and Neurovascular Diseases Bucharest, Bucharest, Romania., Chelmambet AS; Department of Neurology, National Institute of Neurology and Neurovascular Diseases Bucharest, Bucharest, Romania., Bucur AI; Department of Neurology, National Institute of Neurology and Neurovascular Diseases Bucharest, Bucharest, Romania., Tuţǎ S; Department of Neurology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.; Department of Neurology, National Institute of Neurology and Neurovascular Diseases Bucharest, Bucharest, Romania.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2022 Oct 19; Vol. 13, pp. 1004132. Date of Electronic Publication: 2022 Oct 19 (Print Publication: 2022).
DOI:	10.3389/fneur.2022.1004132
Abstrakt:	Neuromyelitis optica spectrum disorders are characterized by severe demyelination and axonal damage with autoimmune mechanisms, predominantly targeting the optic nerves and the spinal cord. Patients often test positive for anti-AQP4 antibodies, while some have anti-MOG antibodies. Double seropositivity has been described, with a variable prevalence (0 to 26%) dependent on the testing method. The clinical significance of double seropositivity remains unclear. We present the case of a 65-year-old patient, admitted to our clinic with optical neuritis, followed up approximately 10 days later by cervical myelitis, who tested positive for both anti-AQP4 and anti-MOG antibodies. The clinical onset coincided with a mild form of SARS-CoV-2 infection. The neurological symptoms were initially relatively subdued, which delayed the diagnosis. The patient was not vaccinated against SARS-CoV-2. The clinical picture was compatible with an anti-AQP4 phenotype. The patient was started on corticosteroid therapy, under which the clinical response was good. Our case reinforces the idea that SARS-CoV-2 can precipitate autoimmune demyelinating diseases since SARS-CoV-2 infection has already been demonstrated as a risk factor for NMOSD relapses. To the best of our knowledge, this is the first reported case of double seropositive neuromyelitis optica associated with COVID-19. We expect that in the near future, as the true burden of COVID becomes clearer, we shall encounter other cases which can trace their apparent clinical onset to a SARS-CoV-2 infection. Careful attention should be paid to the apparent minor neurological symptoms of COVID-19. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Antonescu Ghelmez, Moraru, Antonescu, Chelmambet, Bucur and Tuţǎ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu