Treatment-resistant neuromyelitis optica spectrum disorders associated with Toxocara canis infection: A case report

Abstract A 53-year-old woman was admitted to our hospital because of progressive thoracic myelitis a month after she had eaten uncooked bovine liver. A previous episode of right optic neuritis and a positive test for serum anti-aquaporin-4 antibodies indicated a diagnosis of neuromyelitis optica spe...

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Bibliographic Details
Published in:Multiple sclerosis and related disorders 2017-04, Vol.13, p.116-118
Main Authors: Kambe, Daisuke, Takeoka, Kayo, Ogawa, Kenta, Doi, Kosuke, Maruyama, Haruhiko, Yoshida, Ayako, Suenaga, Toshihiko, Kageyama, Takashi
Format: Article
Language:English
Subjects:
Albendazole - therapeutic use
Anti-aquaporin 4 antibodies
Antibodies - blood
Antiprotozoal Agents - therapeutic use
Aquaporin 4 - immunology
Drug Resistance
Female
Humans
Methylprednisolone - therapeutic use
Middle Aged
Neurology
Neuromyelitis Optica - complications
Neuromyelitis Optica - drug therapy
Neuromyelitis Optica - immunology
Neuromyelitis optica spectrum disorders
Toxocariasis
Toxocariasis - complications
Toxocariasis - immunology
Transverse myelitis
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Summary:Abstract A 53-year-old woman was admitted to our hospital because of progressive thoracic myelitis a month after she had eaten uncooked bovine liver. A previous episode of right optic neuritis and a positive test for serum anti-aquaporin-4 antibodies indicated a diagnosis of neuromyelitis optica spectrum disorders. Although the patient initially recovered with the reduction of anti-aquaporin-4 antibodies during treatment with intravenous methylprednisolone infusion and plasma exchange, her neurological symptoms deteriorated soon after the completion of plasma exchange. Western blotting analysis detected anti- Toxocara canis antibodies in the serum; thus, the patient underwent oral albendazole treatment. This resulted in the alleviation of her symptoms. We therefore consider that rigorous investigation should be encouraged to detect rare pathogens including parasites in cases of treatment-resistant neuromyelitis optica spectrum disorders.
ISSN:2211-0348
2211-0356
DOI:10.1016/j.msard.2017.02.014