Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation

Neuromyelitis optica with a positive aquaporin-4 antibody is a rare autoimmune condition, which has a higher prevalence in females, and disproportionately affects Black and Asian persons with a typical age of first presentation between the ages of 30 and 40. We report a unique case of a 69-year-old...

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Main Authors: Monideep Ghosh, Nesta Baxter, Michael Homer-Ward
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251356911
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author Monideep Ghosh
Nesta Baxter
Michael Homer-Ward
author_facet Monideep Ghosh
Nesta Baxter
Michael Homer-Ward
author_sort Monideep Ghosh
collection DOAJ
description Neuromyelitis optica with a positive aquaporin-4 antibody is a rare autoimmune condition, which has a higher prevalence in females, and disproportionately affects Black and Asian persons with a typical age of first presentation between the ages of 30 and 40. We report a unique case of a 69-year-old Caucasian male who presented following a fall along with generalised weakness, unilateral myotomal pain, and urinary dysfunction. His medical history included two previous venous thromboembolic events, for which he was anticoagulated with warfarin. Extensive investigations, including MRI of the whole spine and lumbar puncture, revealed longitudinally extensive transverse myelitis and a positive aquaporin-4 antibody, confirming neuromyelitis optica. The patient was treated with intravenous methylprednisolone, plasma exchange, and immunoglobulin therapy, followed by rehabilitation. This case highlights the importance of considering neuromyelitis optica in atypical patient demographics and that early recognition through neurological assessment, imaging, and antibody testing is critical in preventing severe disability.
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spelling doaj-art-45c8ebf0343244b7af4a2f2f3cafacbe2025-08-20T03:28:41ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-07-011310.1177/2050313X251356911Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentationMonideep Ghosh0Nesta Baxter1Michael Homer-Ward2Portsmouth Hospitals University NHS Trust, Portsmouth, UKNorfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UKPortsmouth Hospitals University NHS Trust, Portsmouth, UKNeuromyelitis optica with a positive aquaporin-4 antibody is a rare autoimmune condition, which has a higher prevalence in females, and disproportionately affects Black and Asian persons with a typical age of first presentation between the ages of 30 and 40. We report a unique case of a 69-year-old Caucasian male who presented following a fall along with generalised weakness, unilateral myotomal pain, and urinary dysfunction. His medical history included two previous venous thromboembolic events, for which he was anticoagulated with warfarin. Extensive investigations, including MRI of the whole spine and lumbar puncture, revealed longitudinally extensive transverse myelitis and a positive aquaporin-4 antibody, confirming neuromyelitis optica. The patient was treated with intravenous methylprednisolone, plasma exchange, and immunoglobulin therapy, followed by rehabilitation. This case highlights the importance of considering neuromyelitis optica in atypical patient demographics and that early recognition through neurological assessment, imaging, and antibody testing is critical in preventing severe disability.https://doi.org/10.1177/2050313X251356911
spellingShingle Monideep Ghosh
Nesta Baxter
Michael Homer-Ward
Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation
SAGE Open Medical Case Reports
title Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation
title_full Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation
title_fullStr Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation
title_full_unstemmed Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation
title_short Aquaporin-4-positive neuromyelitis optica in a male Caucasian patient: A rare demographic presentation
title_sort aquaporin 4 positive neuromyelitis optica in a male caucasian patient a rare demographic presentation
url https://doi.org/10.1177/2050313X251356911
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AT michaelhomerward aquaporin4positiveneuromyelitisopticainamalecaucasianpatientararedemographicpresentation