Fulan Shan, Youming Long, Yongxiang Fan, Mengyu Chen, Yangbo Zheng and Cong Gao
Background: Neuromyelitisoptica spectrum disorder (NMOSD) is a series of central nervous system diseases with positive aquaporin-4 antibody. And neurosyphilis is a manifestation of the late syphilis. Although Neuromyelitisoptica (NMO) following syphilis has been previously reported, transverse myelitis and neurosyphilis in the same patient with positive aquaporin-4 antibody has never been mentioned.
Method: We presented the coexistence of NMOSD and syphilis in a 72-year-oldChinese woman and analyzed the relationship of these two diseases. The pertinent literatures were also reviewed.
Result: Previous studies showed that syphilitic myelitis might be more frequent in male than in female and it tended to be asymptomatic. However our case was a woman who experienced acute attack, with positive AQP4 antibody. Therefore, her myelitis occurrence mainly associated with AQP4 antibodies autoimmunity, and neurosyphilis might be an asymptomatic episode in our case. Although there was no evidence that treponema pallidum subspecies pallidum involved in the pathogenesis of NMO, it seemed that anti-syphilitic treatment was helpful to attenuate disability in our present case.
Conclusion: Anti-NMO and anti-syphilitic treatment should be used together to treat the patient with both NMOSD and neurosyphilis.
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