RESUMO
Neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, which preferentially attacks the optic nerve and spinal cord. It is associated with antibodies against aquaporin 4. Morbidity and mortality are higher than in multiple sclerosis and its treatment focuses on immunosuppressive drugs. Immunomodulators are contraindicated. We report a previously healthy 35-year-old man, presenting with NMO concomitantly with systemic lupus erythematosus. His evolution was torpid with three outbreaks in the 10 months after the diagnosis, requiring a first-line therapy with methylprednisolone and cyclophosphamide and then a second-line therapy with rituximab.
Assuntos
Humanos , Masculino , Adulto , Neuromielite Óptica/complicações , Lúpus Eritematoso Sistêmico/complicações , Paresia/complicações , Paresia/tratamento farmacológico , Espasmo/complicações , Espasmo/tratamento farmacológico , Metilprednisolona/uso terapêutico , Neuromielite Óptica/tratamento farmacológico , Antirreumáticos/uso terapêutico , Ciclofosfamida/uso terapêutico , Rituximab/uso terapêutico , Glucocorticoides/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológicoRESUMO
Neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, which preferentially attacks the optic nerve and spinal cord. It is associated with antibodies against aquaporin 4. Morbidity and mortality are higher than in multiple sclerosis and its treatment focuses on immunosuppressive drugs. Immunomodulators are contraindicated. We report a previously healthy 35-year-old man, presenting with NMO concomitantly with systemic lupus erythematosus. His evolution was torpid with three outbreaks in the 10 months after the diagnosis, requiring a first-line therapy with methylprednisolone and cyclophosphamide and then a second-line therapy with rituximab.