Neuromyelitis optica (Devic's disease) in a case of systemic lupus erythematosus with antiphospholipid antibodies: is there a role for anticoagulants?

Abstract

We report a case of transverse myelitis and bilateral optic neuritis (neuromyelitis optica or Devic's disease) in a patient with systemic lupus erythematosus (SLE) and antiphospholipid antibodies. Investigation included neuroimaging, electrophysiology, visual fields, and determination of antiphospholipid antibodies. Devic's disease is an extremely rare manifestation of SLE and recent advances in the histopathologic understanding of this condition, including the disassociation from demyelination and a postulated link to vascular disease with axonal necrosis, suggest the implication of antiphospholipid antibodies in the pathophysiology of at least some cases of the disease and the potential favorable effect of anticoagulation.

• Devic's Disease
• Systemic Lupus Erythematosus
• Antiphospholipid Antibodies