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Neuromyelitis optica spectrum disorder as a paraneoplastic syndrome: a rare and challenging diagnosis
  1. Mukhtar Gibril1 and
  2. Richard Walters2
  1. 1General Medicine, Morriston Hospital, Swansea, UK
  2. 2Neurology Department, Morriston Hospital, Swansea, UK
  1. Correspondence to Dr Mukhtar Gibril; mukhtarbabiker{at}


Neuromyelitis optica spectrum disorder (NMOSD) is an uncommon antibody-mediated disease of the central nervous system, often associated with aquaporin-4 antibodies (AQP4-Ab). NMOSD may present as a subacute myelopathy, progressing over days with MRI revealing a contiguous inflammatory lesion of the spinal cord, ≥3 vertebral segments, a longitudinally extensive transverse myelitis. We describe an unusual paraneoplastic form of AQP4-Ab NMOSD that developed in a patient with an advanced diffuse large B-cell lymphoma. The patient had an unusual hyperacute onset, reaching a clinical nadir within hours.

  • haematology (drugs and medicines)
  • neurology (drugs and medicines)
  • radiology

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  • Contributors MG: participated directly in the patient’s clinical care, and the construction, image formatting and editing of this manuscript. RW: the patient was under his care as he is a consultant neurologist. He participated in the construction and editing of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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