Anti-ganglioside antibody positive neuromyelitis optica spectrum disease with peripheral neuropathy: a case report

Abstract

Abstract Background Neuromyelitis optica spectrum disease (NMOSD) is a demyelinating disease of the central nervous system primarily involving the optic nerve and spinal cord. There are limited reports of NMOSD associated with peripheral nerve damage. Case presentation We report a 57-year-old female patient who met the diagnostic criteria for aquaporin-4 (AQP4) IgG-positive NMOSD with undifferentiated connective tissue disease andmultiple peripheral neuropathy. In addition, the patient was positiveformultiple anti-ganglioside antibodies (anti-GD1a IgG antibodies and anti-GD3 IgM antibodies) and anti-sulfatide IgG antibodies in serum and cerebrospinal fluid. After treatment with methylprednisolone, gamma globulin, plasma exchange, and rituximab, the patient’s status improved and was subsequently discharged from our hospital. Conclusions The neurologist should be aware of the unusual association between NMOSD and immune-mediated peripheral neuropathy. Undifferentiated connective tissue disease and nerve damage mediated by multiple antibodies may have combined to cause peripheral nerve damage in this patient.