Dados do Trabalho
PEDIATRIC OPTIC NEURITIS WITH NON-REACTIVE ANTIBODIES: CASE REPORT
Apresentação do caso
A 10 years old, male, without comorbidities, evolved with low visual acuity in the right eye and amaurosis in the left eye. The fundoscopy revealed significant bilateral optic disc edema. Brain Tomography and brain Magnetic Resonance Imaging (MRI) were performed, without any abnormalities. Laboratory tests showed reactive cytomegalovirus IgG, positive IgG for Epstein–Barr virus, positive IgM for Zika Virus and high Complement C4, with values of 43mg/ml. In question, Anti-QP-4, Oligoclonal Bands and IgG for MOG was non-reactive.
The optic neuritis (OS) is defined as a pathological process characterized by inflammation of one or both optic nerves. The visual prognosis and the risk of recurrent lesions vary depending on their etiology and involvement. Pediatric optic neuritis is usually bilateral and anterior associated with papillitis. It can be associated with viral infection, although the pathogen is rarely identified or can be a manifestation of an acquired demyelinating syndrome. Usually, the optic neuritis has a good prognosis in this age group. At this case, the optic neuritis didn't present positive antibodies for MOGAD, Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder, but as an isolated syndrome. Recognizing the disease can help us to provide a better treatment to the patient and clear prognosis.
Although the patient in question was double seronegative, he had a severe visual loss. Anti-AQP-4 and Anti-MOG antibodies are indispensable in the investigation of pediatric optic neuritis in order to make the differential diagnosis between Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder and MOGAD. Despite being rare, the optic neuritis can cause serious repercussions in the patient. However, the course of optic neuritis in the pediatric age group usually has a good prognosis. The treatment consists of reducing inflammation and relieving symptoms, in order to improving visual acuity.
Referências (se houver)
Optic neuritis; Pediatrics; Demyelinating Disease.
Fonte de Fomento (se houver)
Declaração de conflito de interesses de TODOS os autores
Declaro não estar submetido a qualquer tipo de conflito de interesse junto aos participantes ou a qualquer outro colaborador, direto ou indireto, para o desenvolvimento do Projeto de Pesquisa intitulado “Pediatric optic neuritis with non-reactive antibodies: case report", cujos pesquisadores envolvidos são: Kaline Luna Castor Camelo, Ana Beatriz Teles de Almeida, Lara Maria Barros de Souza, Maria Emanuelle Ferreira de Morais, Milena Beatriz Benício Neves, Ana Clara Guilherme Rodrigues, Ingrid Lacerda Pessoa, Bianca Etelvina Santos de Oliveira e Gilvan Valdevino da Costa Filho.
Neuroimunologia, esclerose múltipla e outras doenças desmielinizantes
Centro de Referência em Esclerose Múltipla da Paraiba - Paraíba - Brasil, Centro Universitário de João Pessoa - Paraíba - Brasil
Kaline Luna Castor Camelo, Ana Beatriz Teles de Almeida, Lara Maria Barros de Souza, Maria Emanuelle Ferreira de Morais, Milena Beatriz Benício Neves, Ingrid Lacerda Pessoa, Ana Clara Guilherme Rodrigues, Bianca Etelvina Santos de Oliveira, Gilvan Valdevino Costa Filho