PDF(Pubmed)
Abstract：
UNASSIGNED: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disorder that principally targets the central nervous system, specifically the spinal cord and optic nerves. NMOSD is often associated with thyroid pathologies such as Graves\' disease or Hashimoto\'s thyroiditis. Thyroid eye disease (TED) is an autoimmune condition characterized by inflammation and hypertrophy of the extraocular muscles. Dysthyroid optic neuropathy (DON), a critical complication of TED, may lead to irreversible visual loss. We report a case of DON complicated by NMOSD.
UNASSIGNED: We report a case of an autoimmune disease presenting as DON in a 44-year-old Japanese woman with a history of Graves\' disease, who experienced reduced visual acuity and orbital pain. Brain magnetic resonance imaging disclosed hypertrophy of the rectus muscles, compressing the optic nerve bilaterally. Consequently, she was diagnosed with DON and underwent three courses of steroid semi-pulse therapy and left orbital decompression surgery, alleviating optic nerve compression. Nevertheless, the visual prognosis remained poor. A subsequent serological test showed positive for aquaporin-4 antibody. Treatment with satralizumab, an interleukin-6 receptor monoclonal antibody, was initiated in conjunction with steroids to suppress the autoimmune response and reduce NMOSD relapse risk. Following this treatment, no NMOSD recurrences were reported.
UNASSIGNED: This case highlights the necessity of considering the possible coexistence of DON and NMOSD in patients with autoimmune diseases.
UNASSIGNED: We report a case of an autoimmune disease presenting as DON in a 44-year-old Japanese woman with a history of Graves\' disease, who experienced reduced visual acuity and orbital pain. Brain magnetic resonance imaging disclosed hypertrophy of the rectus muscles, compressing the optic nerve bilaterally. Consequently, she was diagnosed with DON and underwent three courses of steroid semi-pulse therapy and left orbital decompression surgery, alleviating optic nerve compression. Nevertheless, the visual prognosis remained poor. A subsequent serological test showed positive for aquaporin-4 antibody. Treatment with satralizumab, an interleukin-6 receptor monoclonal antibody, was initiated in conjunction with steroids to suppress the autoimmune response and reduce NMOSD relapse risk. Following this treatment, no NMOSD recurrences were reported.
UNASSIGNED: This case highlights the necessity of considering the possible coexistence of DON and NMOSD in patients with autoimmune diseases.
摘要：
■视神经脊髓炎谱系障碍（NMOSD）是一种主要针对中枢神经系统的自身免疫性疾病，特别是脊髓和视神经。NMOSD通常与甲状腺病理如Graves病或桥本甲状腺炎有关。甲状腺眼病（TED）是一种自身免疫性疾病，其特征在于眼外肌的炎症和肥大。甲状腺功能异常视神经病变(DON),TED的一个关键并发症，可能导致不可逆的视力丧失。我们报告了一例DON并发NMOSD的病例。
我们报告了一例自身免疫性疾病，表现为DON的44岁日本女性，有格雷夫斯病病史，视力下降和眼眶疼痛。脑磁共振成像显示直肌肥大，两侧压迫视神经.因此,她被诊断出患有DON，并接受了三个疗程的类固醇半脉冲疗法和左眶减压手术，减轻视神经压迫.然而，视力预后仍然较差。随后的血清学测试显示水通道蛋白4抗体呈阳性。用satralizumab治疗，白细胞介素-6受体单克隆抗体，与类固醇一起开始抑制自身免疫反应并降低NMOSD复发风险。经过这种治疗,无NMOSD复发报告.
■该案例强调了在自身免疫性疾病患者中考虑DON和NMOSD可能共存的必要性。
我们报告了一例自身免疫性疾病，表现为DON的44岁日本女性，有格雷夫斯病病史，视力下降和眼眶疼痛。脑磁共振成像显示直肌肥大，两侧压迫视神经.因此,她被诊断出患有DON，并接受了三个疗程的类固醇半脉冲疗法和左眶减压手术，减轻视神经压迫.然而，视力预后仍然较差。随后的血清学测试显示水通道蛋白4抗体呈阳性。用satralizumab治疗，白细胞介素-6受体单克隆抗体，与类固醇一起开始抑制自身免疫反应并降低NMOSD复发风险。经过这种治疗,无NMOSD复发报告.
■该案例强调了在自身免疫性疾病患者中考虑DON和NMOSD可能共存的必要性。
