Fuyong Qiang
1 
, Zhi Li
1 , Lanfang Chen
1, Dan Xuan
1, Jun Sheng
1* 1 Department of Rheumatism and Immunology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
Abstract
A patient with longstanding rheumatoid arthritis (RA) complained of spinal cord symptoms after RA relapse. Contrast MRI demonstrated neuromyelitis in the upper thoracic spinal cord, and anti-aquaporin-4 (anti-AQP4) antibody was positive in the serum and cerebrospinal fluid (CSF). Neuromyelitis optica spectrum disorder (NMOSD) was diagnosed after excluding central nervous system (CNS) infection and tumor, and spinal cord symptoms were relieved after high dose of glucocorticoid and immunosuppressant were initiated for treatment.