Neuropatía óptica autoinmune recidivante bilateral en la infancia / Bilateral recurrent autoimmune optical neuropathy in childhood

RESUMEN

Caso clínico Niña de 10 años, que tras gastroenteritis por Yersinia debuta con neuritis óptica en ojo izquierdo. No recibe tratamiento y evoluciona a atrofia óptica. A los 6 meses presentó un episodio en el ojo contralateral, instaurándose tratamiento corticoideo. Durante su disminución progresiva sufre tres recaídas. Se decide instaurar tratamiento con inmunosupresores, manteniéndose estable desde entonces sin efectos secundarios. Discusión: Tras descartar las múltiples causas de neuritis óptica bilateral recidivante en una niña, se concluye que la etiología era autoinmune. Valorando los beneficios y riesgos del tratamiento con inmunosupresores creemos que permiten el control de la enfermedad y el ahorro corticoideo (AU)

ABSTRACT

Clinical case A ten year-old girl, after a Yersinia gastroenteritis, developed an optic neuritis in the left eye. She was not treated and resulted ultimately in optic atrophy on the affected side. Six months later a similar episode occurred in the contralateral eye. On this occasion corticosteroid therapy was given. During this therapy the neuritis diminished; however the patient had three relapses, so it was decided to give her immunosuppressive treatment with azathioprine and continue this indefinitely. Discussion: After considering the differential diagnoses of bilateral recurrent optical neuritis in childhood, we concluded that it was most likely to have an autoimmune basis. After considering the benefits and risks of the long-term treatment, we believe immunosuppressive therapy is most useful in controlling the disease allowing corticosteroid therapy to be reduced (AU)