Seropositive Neuromyelitis optica in a case of undiagnosed ankylosing spondylitis : a neuro-rheumatological conundrum

Abstract EN

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathy against foot processes of aquaporin-4 (AQP4) water channels.

Patients with NMOSD tend to have other coexisting autoimmune/connective tissue diseases.

However, AQP-4-antibody-positive NMOSD coexisting with ankylosing spondylitis (AS) is rare.

AS is an immune-mediated disorder, a subset of axial spondyloarthropathies, which commonly manifests as chronic inflammatory back pain in young people, and it has a strong association with HLA-B27.

In this study, a 35-year-old Indian man with an undiagnosed progressive axial spondyloarthropathy (i.e., AS) is reported presenting with acute-onset longitudinally extensive transverse myelitis, a clinical subset of NMOSD.