Losing Sight of the Diagnosis: A Case Report of Neuromyelitis Optica Spectrum Disease and Systemic Lupus Erythematosus-Neuroautoimmunity in Focus, Correlation or Coincidence?

This case report discusses a 64-year-old female patient diagnosed with coexistent Neuromyelitis Optica Spectrum Disease (NMOSD) and Systemic Lupus Erythematosus (SLE), presenting with severe vision loss due to optic neuritis. The diagnosis was supported by elevated anti-aquaporin-4 antibodies and hypocomplementemia. Treatment with glucocorticoids and Rituximab resulted in mild visual improvement and resolution of thrombocytopenia, with no relapses over a 2-year follow-up. The report emphasizes the diagnostic challenges and importance of distinguishing between NMOSD and SLE for effective treatment, as both conditions share overlapping traits but require different therapeutic approaches.