RESUMO
We report the case of a 57-year-old man with neuromyelitis optica spectrum disorder (NMOSD) presenting as acute eosinophilic encephalomyelitis. Magnetic resonance imaging revealed central nervous system lesions typical of NMOSD and anti-aquaporin-4 antibodies in the serum were identified; however, eosinophilia was evident in the cerebrospinal fluid (CSF) at the early stage of the disease. The number of eosinophils in the CSF decreased subsequently. Although activation of eosinophils is known to be an important factor in the development of NMOSD lesions, prominent eosinophilia in the CSF at the early stage of the disease has never been reported in patients with NMOSD.
Assuntos
Anticorpos Anti-Idiotípicos/imunologia , Aquaporina 4/imunologia , Encefalomielite/imunologia , Neuromielite Óptica/imunologia , Anti-Inflamatórios/uso terapêutico , Anticorpos Anti-Idiotípicos/líquido cefalorraquidiano , Aquaporina 4/líquido cefalorraquidiano , Encefalomielite/líquido cefalorraquidiano , Encefalomielite/terapia , Eosinófilos , Humanos , Imunoglobulina E/imunologia , Contagem de Leucócitos , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Neuromielite Óptica/líquido cefalorraquidiano , Neuromielite Óptica/terapiaRESUMO
We report a 52-year-old Japanese man showing both upper and lower motor neuron signs with familial amyotrophic lateral sclerosis (ALS). Analysis of the TAR DNA-binding protein of 43 kDa (TDP-43) gene (TARDBP) revealed a glycine-to-serine substitution at position 298 (G298S). Cerebrospinal fluid (CSF) level of total tau protein (CSF-tau) of our patient was found to be highly elevated compared with those of sporadic ALS cases and controls. The elevated CSF-tau level might be related to the damage of neurons exhibiting a large number of TDP-43 inclusions in familial ALS with this mutation.