Herpes Zoster Precipitating First Attack of Neuromyelitis Optica Along with Perinuclear Anti-Neutrophilic Cytoplasmic Antibody Positive Vasculitis
January 2022
in “
Annals of Indian Academy of Neurology
”
methylprednisolone acyclovir immunomodulators anti-aquaporin-4 p-ANCA vasculitis herpes zoster Neuromyelitis Optica Spectrum Disorder longitudinally extensive transverse myelitis steroids Zovirax immune system modulators anti-AQP4 perinuclear anti-neutrophilic cytoplasmic antibody shingles NMOSD LETM
TLDR A woman's shingles infection triggered her first episode of a rare neurological disorder and blood vessel inflammation.
A 32-year-old female presented with a painful rash and subsequent neurological symptoms, leading to a diagnosis of Neuromyelitis Optica Spectrum Disorder (NMOSD) with longitudinally extensive transverse myelitis (LETM) and positive anti-aquaporin-4 and p-ANCA antibodies, precipitated by a herpes zoster infection. This case highlights the rare association of herpes zoster with NMOSD and systemic vasculitis, suggesting that infections can trigger autoimmune responses leading to demyelinating disorders. The patient responded well to treatment with methylprednisolone, acyclovir, and immunomodulators, showing significant recovery. Further studies are needed to understand the immunopathogenesis of such co-existent disorders for early diagnosis and better outcomes.
