A 35-year-old woman presents with recurrent episodes of severe bilateral vision loss and longitudinally extensive spinal cord inflammation causing paraplegia and urinary retention. Vital signs show BP 128/82, HR 88, RR 16, temperature 37.2°C, and SpO2 98% on room air. Brain MRI is unremarkable. Spinal MRI demonstrates T2 hyperintensity extending over 3 vertebral segments. Serum aquaporin-4 antibody is positive. Which of the following is the most likely diagnosis?
- A)Progressive multifocal leukoencephalopathy
- B)Acute disseminated encephalomyelitis
- C)Transverse myelitis
- D)Neuromyelitis opticaGABARITO
- E)Multiple sclerosis
Explicação
The combination of optic neuritis with longitudinally extensive transverse myelitis and relatively spared brain imaging suggests neuromyelitis optica. This disorder is typically associated with anti aquaporin 4 antibodies and is distinct from classic multiple ... Ver explicação completa e trilha adaptativa →