Abstract Details

Title SARS-CoV-2 associated Neuromyelitis optica

Topic Autoimmune Neurology

Presentation(s) Autoimmune Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 009

Objective Not applicable

Background SARS-CoV-2 has been shown to cause numerous neurologic sequelae, including meningoencephalitis, ischemic or hemorrhagic stroke, and acute disseminated encephalomyelitis. Following respiratory symptoms, acute transverse myelitis has also been reported. Neuromyelitis Optica (NMO) is a rare, inflammatory demyelinating disease of the central nervous system (CNS), predominantly affecting the optic nerves and spinal cord. NMO is diagnosed by the presence of at least 1 of 6 core clinical characteristics and detection of AQP4-IgG. The core clinical characteristics implicate 6 CNS regions including optic nerve, spinal cord, area postrema of the dorsal medulla, brainstem, diencephalon, or cerebrum. Some studies of NMO have suggested a triggering role for infectious agents, but the primary immunizing event remains poorly understood.

Design/Methods Not applicable

Results We report a case of NMO occurring in a patient who initially presented with acute meningoencephalitis of unknown etiology and, shortly thereafter, was found to be SARS-CoV-2 antibody positive. Our patient had 2 core clinical characteristics including spinal cord lesion spanning greater than 3 segments and area postrema syndrome due to dorsal medullary lesion. Furthermore, his serum AQP4-IgG was positive. He developed these symptoms after becoming seropositive for SARS-CoV-2 antibodies with a positive nasopharyngeal swab test.

Conclusions

This is the first case report about NMO potentially triggered by SARS-CoV-2 infection. While causality remains difficult to prove, the temporal relationship between SARS-CoV-2 infection and NMO attack is compelling for parainfectious phenomenon.

Authors/Disclosures
Tzu-ying Chuang, MD, PhD PRESENTER	Dr. Chuang has nothing to disclose.
Dhanashri P. Miskin, MD (Thomas Jefferson University)	Dr. Miskin has nothing to disclose.

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