Successful treatment of steroid-resistant anti-aquaporin 4 antibody-positive optic neuritis with double-filtration plasmapheresis: a case report

Fukuda-Hihara Kei, Iyoda Masayuki, Saito Tomohiro, Arai-Nunota Noriko, Wada Yukihiro, Suzuki Sachie, Kizaki Junichiro, Onda Hidetoshi, Takahashi Haruo, Shibata Takanori

doi:10.4009/jsdt.51.379

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Other Title

ステロイド抵抗性の抗アクアポリン4抗体陽性視神経炎に対し二重膜濾過血漿交換療法が奏功した1例
症例報告ステロイド抵抗性の抗アクアポリン4抗体陽性視神経炎に対し二重膜濾過血漿交換療法が奏功した1例
ショウレイホウコクステロイドテイコウセイノコウアクアポリン 4 コウタイヨウセイシシンケイエンニタイシニジュウマクロカケッショウコウカンリョウホウガソウコウシタ 1レイ

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<p>A 30-year-old female visited a local hospital with complaints of pain upon right eye movement, anorthopia, and visual field contraction in her right eye, which had lasted for 4 days. Her right visual acuity subsequently rapidly worsened. Anti-aquaporin-4 (AQP4) antibodies were detected in her serum, and high-intensity lesions were found in the right optic nerve on T1-weighted magnetic resonance imaging. On the basis of these findings, she was diagnosed with anti-AQP4 antibody-positive optic neuritis. Although she was treated with 2 courses of steroid pulse therapy followed by 40 mg/day of prednisolone, it had no beneficial effects. So, she was referred to our hospital, where she underwent double-filtration plasmapheresis (DFPP). After a total of 7 sessions of DFPP, the anti-AQP4 antibodies disappeared, and the patient’s visual function gradually recovered. In conclusion, DFPP seems to be a useful therapeutic option for steroid-resistant anti-AQP4 antibody-positive optic neuritis.</p>

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Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 51 (6), 379-385, 2018

The Japanese Society for Dialysis Therapy

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