Neuromielitis óptica como manifestación del lupus eritematoso sistémico: reporte de caso

Neuromyelitis optica spectrum disorder affects the spinal cord and optic nerves, and its coexistence with systemic lupus erythematosus poses a diagnostic challenge. The study therefore aimed to describe the clinical presentation, diagnostic process and management of a case of seronegative neuromyelitis optica spectrum disorder associated with systemic lupus erythematosus. A case report following the CARE guideline was used, involving a 36-year-old woman previously diagnosed with rheumatoid arthritis who developed longitudinally extensive myelitis, quadriparesis and blurred vision. Anti-double-stranded DNA, anti-Sm, anti-SSA and anti-SSB were positive, anti-aquaporin-4 antibodies were negative and cerebrospinal fluid protein was elevated, with full recovery of strength after four cyclophosphamide pulses. It was concluded that immunological characterisation and multidisciplinary management are decisive.