Neuromyelitis optica spectrum disorder (NMOSD) is a disabling autoimmune astrocytopathic channelopathy, characterized by the presence of pathogenic antibodies to aquaporin-4 (AQP-4) water channels. Several viral infections including HIV, influenza virus, varicella zoster virus, and Epstein Barr virus, among others, have been alleged to trigger NMOSD in both immunocompetent and immunocompromised individuals. Neurological manifestations of coronavirus infectious disease of 2019 (COVID-19) have been ever evolving and the spectrum of neuraxial involvement is broadening. Albeit it may affect any area of the neural axis, the involvement of the spinal cord is rare compared to that of the brain and of the peripheral nervous system. Cases with acute longitudinally extensive transverse myelitis (LETM) have been recently reported in SARS-CoV-2 infection but did not fulfill the international consensus diagnostic criteria for NMOSD. AQP-4-antibody-seropositive NMOSD following SARS-CoV-2 infection had not yet been reported. We herein report a novel case of a previously healthy man who presented with a clinical picture of bouts of vomiting and hiccoughs (area postrema syndrome), which rapidly evolved to acute LETM, all following SARS-CoV-2 infection. He was finally diagnosed to be a case of seropositive NMOSD which presented as area postrema syndrome. The response to immunomodulatory drugs was excellent.

中文翻译：

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一例 SARS-CoV-2 感染后视神经脊髓炎谱系障碍的区域后变异型

视神经脊髓炎谱系障碍 (NMOSD) 是一种致残性自身免疫性星形细胞病通道病，其特征是存在针对水通道蛋白 4 (AQP-4) 水通道的致病性抗体。据称，包括 HIV、流感病毒、水痘带状疱疹病毒和 Epstein Barr 病毒在内的几种病毒感染会在免疫功能正常和免疫功能低下的个体中引发 NMOSD。2019 年冠状病毒传染病 (COVID-19) 的神经系统表现一直在演变，神经轴受累的范围正在扩大。尽管它可能影响神经轴的任何区域，但与大脑和周围神经系统的受累相比，脊髓受累是罕见的。最近在 SARS-CoV-2 感染中报告了急性纵向广泛性横贯性脊髓炎 (LETM) 病例，但不符合 NMOSD 的国际共识诊断标准。尚未报告 SARS-CoV-2 感染后 AQP-4 抗体血清阳性 NMOSD。我们在此报告了一个新病例，一名先前健康的男性出现了一系列呕吐和打嗝（后区综合征）的临床表现，并在 SARS-CoV-2 感染后迅速演变为急性 LETM。他最终被诊断为血清阳性 NMOSD 病例，表现为区域后区综合征。对免疫调节药物的反应非常好。我们在此报告了一个新病例，一名先前健康的男性出现了一系列呕吐和打嗝（后区综合征）的临床表现，并在 SARS-CoV-2 感染后迅速演变为急性 LETM。他最终被诊断为血清阳性 NMOSD 病例，表现为区域后区综合征。对免疫调节药物的反应非常好。我们在此报告了一个新病例，一名先前健康的男性出现了一系列呕吐和打嗝（后区综合征）的临床表现，并在 SARS-CoV-2 感染后迅速演变为急性 LETM。他最终被诊断为血清阳性 NMOSD 病例，表现为区域后区综合征。对免疫调节药物的反应非常好。