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<p>A 14-year-old girl developed aquaporin-4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder (NMOSD) following <i>Mycoplasma pneumoniae</i> infection. She initially presented with fever, vomiting, seizures and respiratory failure. Brain magnetic resonance imaging revealed isolated splenial lesions. However, she subsequently developed extensive lesions in the hypothalamus, brainstem and spinal cord. Serum and cerebrospinal fluid tested positive for anti-AQP4 antibodies. She was diagnosed with AQP4-IgG-positive NMOSD and treated with corticosteroids, leading to clinical stabilisation. This case provides evidence that <i>M. pneumoniae</i> infection may trigger AQP4-antibody-positive NMOSD, possibly through molecular mimicry. Clinicians should be aware of this potential association, and further research is needed to understand the underlying mechanisms.</p>

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Mycoplasma pneumoniae infection and concurrent aquaporin-4-positive neuromyelitis optica spectrum disorder: a case report and literature review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月3日

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  • Hong Liang,
  • Yuwen Chen,
  • Pimei Zheng

摘要

A 14-year-old girl developed aquaporin-4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder (NMOSD) following Mycoplasma pneumoniae infection. She initially presented with fever, vomiting, seizures and respiratory failure. Brain magnetic resonance imaging revealed isolated splenial lesions. However, she subsequently developed extensive lesions in the hypothalamus, brainstem and spinal cord. Serum and cerebrospinal fluid tested positive for anti-AQP4 antibodies. She was diagnosed with AQP4-IgG-positive NMOSD and treated with corticosteroids, leading to clinical stabilisation. This case provides evidence that M. pneumoniae infection may trigger AQP4-antibody-positive NMOSD, possibly through molecular mimicry. Clinicians should be aware of this potential association, and further research is needed to understand the underlying mechanisms.