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Case Reports
. 2025 Jan 8;8(1):6.
doi: 10.3390/reports8010006.

Navigating Complexity in Pediatric NMOSD: Unusual Symptoms and Adverse Reactions: A Case Report

Oana-Aurelia Vladâcenco  1   2 , Radu-Ștefan Perjoc  1   2 , Eugenia Roza  1   2 , Raluca Ioana Teleanu  1
Affiliations
Case Reports

Navigating Complexity in Pediatric NMOSD: Unusual Symptoms and Adverse Reactions: A Case Report

Oana-Aurelia Vladâcenco et al. Reports (MDPI). .

Abstract

Background and Clinical Significance: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune demyelinating disorder of the central nervous system, characterized by the presence of aquaporin-4 (AQP4) antibodies and a high relapse rate. We provide information about the diagnosis, unusual symptoms, and treatment of a paediatric patient with NMOSD. Case Presentation: A 14-year-old girl was hospitalized for weakness and paraesthesia of the lower limbs (LL). The patient underwent detailed investigations and was diagnosed with NMOSD and cryptogenic organizing pneumonia. Initial treatment with methylprednisolone and prednisone yielded a favourable response. Therapy with mycophenolate was initiated. However, the patient experienced two more relapses, prompting the use of rituximab therapy with a favourable outcome and a two-year relapse-free follow-up period. Conclusions: Patients with NMOSD may have multisystemic inflammation, including organs outside the central nervous system. Our case report highlights a case of NMOSD, pulmonary involvement, and unusual adverse reactions to rituximab.

Keywords: AQP4 antibodies; NMOSD; demyelinating disorder; paediatric.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Spinal MRI showing cervical and thoracic (C6-T8) hyperintense lesions on T2-weighted imaging (White arrows).
Figure 2
Figure 2
(A,B) CT scan of the chest showing ground opacities and patchy consolidation in the periphery of the right lower (white arrows) lobe before methylprednisolone.
Figure 3
Figure 3
CT scan of the chest after treatment with methylprednisolone.
Figure 4
Figure 4
CT scans of the chest during the first relapse, showing ground opacities (white arrows) in the right lower lobe.
See this image and copyright information in PMC

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