A 28-year-old man presents with acute transverse myelitis causing total paraplegia and sensory level at T6. Vital signs show BP 128/82, HR 88, RR 16, temp 37.2°C, SpO2 98%. Days later, he develops severe bilateral optic neuritis with blindness. Brain MRI shows no demyelinating lesions. Serum aquaporin-4 (AQP4) antibodies are positive. CSF oligoclonal bands are negative. He takes no prior medications. Which diagnosis best explains these findings?
- A)Transverse myelitis from viral infection
- B)Spinal cord infarction with coincidental optic neuritis
- C)Multiple sclerosis
- D)Acute inflammatory demyelinating polyradiculoneuropathy
- E)Neuromyelitis optica spectrum disorderGABARITO
Explicação
Neuromyelitis optica spectrum disorder (NMOSD) is characterized by severe transverse myelitis and optic neuritis, often occurring in close temporal proximity. AQP4 antibody positivity is diagnostic and occurs in ~80% of NMOSD cases. The severe, longitudinally ... Ver explicação completa e trilha adaptativa →