Refractory neuromyelitis optica spectrum disorder in systemic lupus erythematosus successfully treated with rituximab

Lupus. 2018 Jul;27(8):1374-1377. doi: 10.1177/0961203318760994. Epub 2018 Mar 2.

Abstract

We present a case of a woman with systemic lupus erythematosus (SLE) who had refractory episodes of neuromyelitis optica spectrum disorder (NMOSD) and was successfully treated with rituximab. She was positive for anti-aquaporin-4 (AQP4) antibody and had typical cranial and longitudinally extended spinal lesions but no optic nerve involvement. There is no established treatment for NMOSD/SLE overlap cases. Our experience suggests that rituximab may be effective for patients with combined SLE and anti-AQP4 antibody-positive NMOSD.

Keywords: Anti-aquaporin-4 antibody; neuromyelitis optica; rituximab; systemic lupus erythematosus.

Publication types

  • Case Reports

MeSH terms

  • Aquaporin 4 / immunology
  • Autoantibodies / blood*
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Magnetic Resonance Imaging
  • Neuromyelitis Optica / complications
  • Neuromyelitis Optica / drug therapy*
  • Rituximab / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Autoantibodies
  • Rituximab