Contributions
Abstract: EP1301
Type: ePoster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Introduction: To describe a case of intractable hiccup and vomiting, followed by new retrobulbar optic neuritis that presented within 8 years of adalimumab treatment initiation in a patient with psoriatic arthritis and prior optic neuritis 4 years ago.
Methods: This case was evaluated with visual field testing, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and laboratory evaluation, and treated with intravenous methylprednisolone followed by plasmapheresis.
Results: A brain and orbital MRI showed T2-weigthed hyperintensity of the postrema area and left optic nerve, this with gadolinium enhancement. CSF findings were 8 cells/µl, with normal protein and absence of oligoclonal IgG bands. Serum aquaporin-4 antibody was negative (analysed by cell-based assays with live transfected cells). Our patient made only a partial visual recovery and was subjected to treatment with Rituximab.
Conclusion: Optic neuritis is a potentially sight-threatening complication of anti-TNF therapy. This unusual case can suggest an additional association: lesion of postrema area and recurrence of severe optic neuritis, both considered spectrum of neuromyelitis optica's phenotype.
Disclosure: Dr Mateus Boaventura receveid grants related to congress meetings from Merck Serono and BiogeneDr Samira Luíza Apóstolos Pereira receveid grants related to congress meetings and preceptorship from Genzyme and Roche
Dr Carolina Rimkus: nothing to disclose
Dr Dagoberto Callegaro receveid grants related to congress meetings and preceptorship from Genzyme, Roche and Biogene
Dr Douglas Sato receveid grants related to congress meetings from Biogene, Novartis, Genzyme, Bayer and Roche
Abstract: EP1301
Type: ePoster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Introduction: To describe a case of intractable hiccup and vomiting, followed by new retrobulbar optic neuritis that presented within 8 years of adalimumab treatment initiation in a patient with psoriatic arthritis and prior optic neuritis 4 years ago.
Methods: This case was evaluated with visual field testing, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and laboratory evaluation, and treated with intravenous methylprednisolone followed by plasmapheresis.
Results: A brain and orbital MRI showed T2-weigthed hyperintensity of the postrema area and left optic nerve, this with gadolinium enhancement. CSF findings were 8 cells/µl, with normal protein and absence of oligoclonal IgG bands. Serum aquaporin-4 antibody was negative (analysed by cell-based assays with live transfected cells). Our patient made only a partial visual recovery and was subjected to treatment with Rituximab.
Conclusion: Optic neuritis is a potentially sight-threatening complication of anti-TNF therapy. This unusual case can suggest an additional association: lesion of postrema area and recurrence of severe optic neuritis, both considered spectrum of neuromyelitis optica's phenotype.
Disclosure: Dr Mateus Boaventura receveid grants related to congress meetings from Merck Serono and BiogeneDr Samira Luíza Apóstolos Pereira receveid grants related to congress meetings and preceptorship from Genzyme and Roche
Dr Carolina Rimkus: nothing to disclose
Dr Dagoberto Callegaro receveid grants related to congress meetings and preceptorship from Genzyme, Roche and Biogene
Dr Douglas Sato receveid grants related to congress meetings from Biogene, Novartis, Genzyme, Bayer and Roche