Neuromyelitis optica with endocrinopathy: further evidence of a new syndrome

Abstract

The precise definition and nosological classification of neuromyelitis optica or Devic’s syndrome remains controversial. Current literature considers neuromyelitis optica to be a clinical syndrome caused by a heterogenous group of demyelinating, infectious, vasculitic, and immunological disorders. We describe a 60-year-old Antillean woman with Devic’s syndrome. She had suffered from three episodes of optic neuritis in the previous five years, and now presented with a progressive myelopathy with spastic paraparesis of the legs, sensory loss below the level of TH10, and constipation. Magnetic resonance imaging of the spinal cord showed myelopathy with cavitation from TH8 to TH10. Blood tests showed an elevation of prolactin and PTH levels, suggestive of endocrinopathy. Considering her nationality, clinical course, MRI findings, and signs of endocrinopathy, we conclude that our case gives further evidence of a new syndrome of neuromyelitis optica with endocrinopathy.