A 28-year-old man presents with acute paraplegia developing over 24 hours. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98% on room air. Examination reveals sensory level at T5 and urinary retention. He denies prior optic neuritis or brain symptoms. MRI of spine demonstrates longitudinally extensive transverse myelitis spanning 4 vertebral levels with central cord involvement. Serum AQP4 antibodies are positive. Which diagnosis best explains these findings?
- A)Spinal cord infarction
- B)Cervical spondylotic myelopathy
- C)Transverse myelitis due to viral infection
- D)Neuromyelitis optica spectrum disorderGABARITO
- E)Multiple sclerosis
Explicação
Neuromyelitis optica spectrum disorder (NMOSD) is defined by AQP4 antibody positivity and episodes of optic neuritis and LETM. LETM (≥3 vertebral segments) is a hallmark feature distinguishing it from MS. AQP4 antibodies target aquaporin-4 channels on astrocyt... Ver explicação completa e trilha adaptativa →