부산대학교 도서관

We report the case of a patient with recurrent refractory bilateral optic neuritis who tested negative for anti-aquaporin-4 (AQP4) antibodies until the third test. A 52-year-old woman was referred to us with recurrence of bilateral optic neuritis previously treated by steroid pulse therapy at another hospital. She was negative for autoantibodies including AQP4 antibody (CBA test). She was diagnosed with recurrent optic neuritis and steroid pulse therapy was administered. She subsequently experienced repeated recurrences of optic neuritis affecting both eyes. Anti-AQP4 antibody tests were consistently negative until the fifth recurrence, when the test for this antibody was positive. Because steroid pulse therapy was not effective, plasma exchange was performed instead. Because seroconversion of anti-AQP4 antibody may occur at any time in patients with neuromyelitis optica (NMO) spectrum disorders, this antibody should be measured several times if a patient has refractory optic neuritis with repeated episodes of recurrence.