Frontiers in Neurology (Nov 2023)

Treating seronegative neuromyelitis optica spectrum disorder with inebilizumab: a case report

  • Dominik Lehrieder,
  • Nikolaos Zapantis,
  • Mirko Pham,
  • Michael Klaus Schuhmann,
  • Axel Haarmann

DOI
https://doi.org/10.3389/fneur.2023.1297341
Journal volume & issue
Vol. 14

Abstract

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BackgroundNeuromyelitis optica spectrum disorder (NMOSD) is a devastating inflammatory disease of the central nervous system that is often severely disabling from the outset. The lack of pathognomonic aquaporin 4 (AQP4) antibodies in seronegative NMOSD not only hinders early diagnosis, but also limits therapeutic options, in contrast to AQP4 antibody-positive NMOSD, where the therapeutic landscape has recently evolved massively.Case presentationWe report a 56-year-old woman with bilateral optic neuritis and longitudinally extensive myelitis as the index events of a seronegative NMOSD, who was successfully treated with inebilizumab.ConclusionTreatment with inebilizumab may be considered in aggressive seronegative NMOSD. Whether broader CD19-directed B cell depletion is more effective than treatment with rituximab remains elusive.

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