Mujer con diagnóstico de novo de espectro de neuromielitis óptica con anticuerpos para AQP4 positivo. Un Reporte de Caso

Contenido principal del artículo

Autores

Neiby Johana Rivera Rojas
Andrea Catalina Nassar Tobón http://orcid.org/0000-0002-1268-0192
Laura Angélica Caballero Amórtegui

Resumen

Introducción: Presentamos el caso de una paciente de 55 años de edad, con antecedente de hipertensión arterial, quien presentó un cuadro de deterioro visual bilateral de 2 meses de evolución, con posterior presencia de un síndrome motor y sensitivo del hemicuerpo derecho asociado a compromiso de tórax y abdomen; las imágenes de resonancia magnética (RM) de cerebro, orbitas, columna cervical y torácica simple y con medio de contraste mostraron una neuritis óptica bilateral severa, asociado a mielopatía cervical longitudinalmente extensa de carácter inflamatorio, hallazgos sugestivos de un espectro de neuromielitis óptica (NMO), por lo que se llevó a toma de punción lumbar que mostró un líquido cefalorraquideo (LCR) con pleocitosis neutrofílica, AQP4 positiva, glucosa y proteínas normales. Recibió manejo con corticoides a altas dosis asociado a plasmaféresis con mejoría parcial de los síntomas; posteriormente se dio de alta, para inicio de manejo inmunomodulador con Rituximab, de forma ambulatoria.     


Objetivo: Describir un caso y las características clínicas generadas en una paciente con neuromielitis óptica, su diagnóstico, tratamiento, evolución y pronóstico.


Método: Se realizó una revisión de la historia clínica y extracción de datos previa firma de consentimiento informado, posteriormente se hizo una búsqueda de artículos de revisión   bibliográfica en PubMed, SCIELO, ProQuest, usando descriptores de Ciencias de la Salud (DeCs) y términos MeSH: reportes de caso, publicaciones y revisiones. Se usaron artículos comprendidos entre 2006 al 2018.


Resultados: Se documentó la presentación clínica, el diagnóstico, evolución y tratamiento de acuerdo con el manejo dado.


Discusión: Al enfrentarnos a un cuadro de una paciente con neuromielitis óptica, podemos encontrar diferentes espectros clínicos, evolución y respuestas al tratamiento.

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Detalles del artículo

Licencia

Derechos de autor 2021 Andrea Catalina Nassar Tobón

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