Devic's syndrome in systemic lupus erythematosus and probable antiphospholipid syndrome

as the immunomodulatory drugs typically used for MS will beineffective for relapse prevention in NMO and severe refractoryattacks in NMO usually necessitate rescue plasmapheresis or moreeffective immunosuppressive therapies [3].In the management of this suspected case of NMO, the authorsmade use of investigatory tools such as cerebrospinal fluid analysisand MRI of the brain/spinal cord in diagnosis. However, asindicated by de Seze et al. [2], even when all these investigatoryarmaments are summoned there is still the pitfall of misdiagnosisand the inability to distinguish the two. Recently, using thetechnique of dual immunostaining, Lennon et al. [4] havedemonstrated that a serum autoantibody marker, NMO-IgG,is highly specific for neuromyelitis optica and can significantlycurtail the diagnostic ambiguity.Perhaps, with the aid of a specific autoantibody marker, themanagement of this patient might have been more streamlined.The authors have declared no conflicts of interest.A. Y. K. C