We present a case of atypical recurrent optic neuritis. A man in his 50s presented with right optic neuritis and profound visual loss, associated with elevated inflammatory markers. Lymph-node biopsy was consistent with sarcoidosis. Aquaporin-4 antibodies were also present. Three months following corticosteroid treatment, his right optic neuritis relapsed, again with raised inflammatory markers. He was started on azathioprine and prednisolone with good effect. A dual diagnosis of sarcoidosis and neuromyelitis optica with aquaporin-4 antibodies is very rare. Long-term immunosuppression is required. The case highlights the importance of identifying the features and cause of atypical optic neuritis.

中文翻译：

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视神经炎患者的结节病和视神经脊髓炎——病例报告

我们提出一例非典型复发性视神经炎病例。一名 50 多岁的男性出现右侧视神经炎和严重的视力丧失，并伴有炎症标志物升高。淋巴结活检与结节病一致。水通道蛋白 4 抗体也存在。皮质类固醇治疗三个月后，他的右侧视神经炎复发，炎症标志物再次升高。他开始服用硫唑嘌呤和泼尼松龙，效果很好。水通道蛋白 4 抗体对结节病和视神经脊髓炎的双重诊断非常罕见。需要长期免疫抑制。该病例强调了识别非典型视神经炎的特征和病因的重要性。