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Correspondence |

Thirty-one Episodes of Myelitis and Optic Neuritis in a Woman With Neuromyelitis Optica and Systemic Lupus Erythematosus

Hannah L. Pellkofer, MD; Reinhard Hohlfeld, MD; Tania Kuempfel, MD
Arch Neurol. 2010;67(6):779-780. doi:10.1001/archneurol.2010.109.
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It was with great interest that we read the article by Nasir et al1 in the September 2009 issue of Archives. The authors impressively describe a patient with neuromyelitis optica (NMO) and lupus erythematosus who experienced 19 episodes of myelitis. Recurrent and severe myelitis attacks occurred despite immunosuppressive treatment with cyclophosphamide or rituximab.

Neuromyelitis optica is an inflammatory disorder of the central nervous system that is classically restricted to the optic nerves and spinal cord. New histopathological and serological findings point to a pathogenic role of serum autoantibodies directed against the aquaporin 4 water channel.2 Treatment options include immunosuppressant medications and, more recently, rituximab, a monoclonal anti-CD20+ B-cell antibody.3

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