TY - JOUR
T1 - Meningoencephalitis-like onset of post-infectious AQP4-IgG-positive optic neuritis complicated by GM1-IgG-positive acute polyneuropathy
AU - Benedetti, Luana
AU - Franciotta, Diego
AU - Beronio, Alessandro
AU - Delucchi, Stefano
AU - Capellini, Cesare
AU - Sette, Massimo Del
PY - 2015/2/17
Y1 - 2015/2/17
N2 - Fifteen days after a respiratory infection, a 45-year-old woman presented with paresthesias in the hands and feet, bilateral loss of vision, fever, headache, and impairment of consciousness. Magnetic resonance imaging (MRI) showed predominant lesions in the optic tracts, optic chiasm, and hypothalamus. Cerebrospinal fluid analysis revealed elevated protein level, and lymphocytic pleocytosis. Neurophysiological studies disclosed a demyelinating sensorimotor polyneuropathy. Serum anti-Mycoplasma pneumoniae immunoglobulin (Ig)M, anti-GM1 IgG, and anti-AQP4 IgG were positive. This case, which is remarkable for post-infectious meningoencephalitis-like onset, MRI picture, and dysimmunity to central and peripheral nervous system autoantigens, underpins the pivotal diagnostic role of anti-AQP4-IgG, and expands the list of clinico-pathological findings that can associate with neuromyelitis optica spectrum disorders.
AB - Fifteen days after a respiratory infection, a 45-year-old woman presented with paresthesias in the hands and feet, bilateral loss of vision, fever, headache, and impairment of consciousness. Magnetic resonance imaging (MRI) showed predominant lesions in the optic tracts, optic chiasm, and hypothalamus. Cerebrospinal fluid analysis revealed elevated protein level, and lymphocytic pleocytosis. Neurophysiological studies disclosed a demyelinating sensorimotor polyneuropathy. Serum anti-Mycoplasma pneumoniae immunoglobulin (Ig)M, anti-GM1 IgG, and anti-AQP4 IgG were positive. This case, which is remarkable for post-infectious meningoencephalitis-like onset, MRI picture, and dysimmunity to central and peripheral nervous system autoantigens, underpins the pivotal diagnostic role of anti-AQP4-IgG, and expands the list of clinico-pathological findings that can associate with neuromyelitis optica spectrum disorders.
KW - AQP4-IgG
KW - Brain lesions
KW - GM1 IgG
KW - Guillain-Barré syndrome
KW - Meningoencephalitis
KW - Neuromyelitis optica spectrum disorders
KW - Optic neuritis
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U2 - 10.1177/1352458514524294
DO - 10.1177/1352458514524294
M3 - Article
C2 - 24557856
AN - SCOPUS:84923096654
VL - 21
SP - 246
EP - 248
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 2
ER -