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. 2019 Mar 11;11(1):7958.
doi: 10.4081/ni.2019.7958.

Neuromyelitis optic with positive Anti-AQP4 and Anti-SSA/Ro antibody

Riwanti Estiasari  1 , Salsabila Firdausia  1 , Dewi Wulandari  2 , Kartika Maharani  1 , Freddy Sitorus  1 , David Pangeran  1 , Darma Imran  1
Affiliations

Neuromyelitis optic with positive Anti-AQP4 and Anti-SSA/Ro antibody

Riwanti Estiasari et al. Neurol Int. .

Abstract

Neuromyelitis Optic (NMO) is an inflammatory disorder involving central nervous system which often co-exists with other autoimmune diseases such as Sjögren's syndrome (SS). NMO manifestation could precede or follow SS, but the role of anti-SSA in the pathogenesis of NMO remains unclear. We present a case of NMO with anti-AQP4 anti-SSA antibody positive. A-44-year-old female presented with right side weakness. The symptoms began with numbness that improved spontaneously. She also complained pain and dry sensations on her eyes. Schirmer test on her left eye, antinuclear antibody (ANA) and anti-SSA antibody were positive. Cervical MRI revealed intramedullary lesion on T2-weighted-image at C2-C5 level. She was diagnosed as NMO with positive anti-AQP4 and probable SS. She received 1g methylprednisolone for 5 days proceeded with mycophenolic acid. One-year observation showed clinical improvement. Systemic autoantibodies must substansially be evaluated in NMO. Comprehensive diagnosis and providing appropriate immuno-suppressant might prevent further disability and relapse.

Keywords: AQP4; Anti-SSA; Neuromyelitis Optic; Sjogren.

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Conflict of interest statement

Conflict of interest: the authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
Cervical magnetic resonance imaging. A) The sagittal T2-weighted image showed hyperintensity in the spinal cord at level C3-C5. B) The axial T2-weighted image on the level of C4 showed hyperintensity in the center of the spinal cord.
Figure 2.
Figure 2.
Cell-based indirect immunofluorescence assay for anti-AQP4 antibody detection. A) negative control; B) positive control; C) Patient serum.
See this image and copyright information in PMC

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