{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:09:19Z","timestamp":1770336559290,"version":"3.49.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n            <jats:title>Introduction:<\/jats:title>\n            <jats:p>The optimal duration of immunosuppressive therapy (IT) for neuromyelitis optica spectrum disorder (NMOSD) has not been established. Here, we report a case of severe relapse after early cessation of IT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case Report:<\/jats:title>\n            <jats:p>A 32-year-old woman presented with a 2-week history of intractable vomiting and hiccups followed by quadriplegia with respiratory insufficiency. Spinal cord MRI showed longitudinally extensive transverse myelitis (LETM) and aquaporin-4-immunoglobulin-G (AQP4-IgG) was positive. She was diagnosed with NMOSD and IT was initiated. She did not experience any clinical attacks during 42 months of IT and her AQP4-IgG status was negative. IT was discontinued on her own decision; 36 months later, the patient experienced a severe LETM relapse with paraplegia, and her AQP4-IgG status reverted to positive.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>This case suggests that clinicians should exercise caution before discontinuing effective IT in patients with NMOSD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/nrl.0000000000000095","type":"journal-article","created":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T10:22:11Z","timestamp":1477995731000},"page":"97-98","source":"Crossref","is-referenced-by-count":6,"title":["Severe Relapse After Cessation of Immunosuppressive Therapy in a Patient With Neuromyelitis Optica Spectrum Disorder"],"prefix":"10.1097","volume":"21","author":[{"given":"Jae-Won","family":"Hyun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayoung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeseul","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In Hye","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-Hyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230929","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3988\/jcn.2011.7.3.115","article-title":"New insights into neuromyelitis optica","volume":"7","author":"Kim","year":"2011","journal-title":"J Clin Neurol"},{"key":"R2-20230929","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s11940-008-0007-z","article-title":"Neuromyelitis optica","volume":"10","author":"Wingerchuk","year":"2008","journal-title":"Curr Treat Options Neurol"},{"key":"R3-20230929","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/1756285611398939","article-title":"Current and future treatment approaches for neuromyelitis optica","volume":"4","author":"Collongues","year":"2011","journal-title":"Ther Adv Neurol Disord"},{"key":"R4-20230929","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jocn.2016.01.009","article-title":"Pediatric familial neuromyelitis optica in two sisters with long term follow-up","volume":"29","author":"Chuquilin","year":"2016","journal-title":"J Clin Neurosci"},{"key":"R5-20230929","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1212\/WNL.0000000000001729","article-title":"International consensus diagnostic criteria for neuromyelitis optica spectrum disorders","volume":"85","author":"Wingerchuk","year":"2015","journal-title":"Neurology"},{"key":"R6-20230929","first-page":"57","article-title":"Azathioprine","volume":"12","year":"2011","journal-title":"Rep Carcinog"},{"key":"R7-20230929","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1093\/brain\/awm062","article-title":"Anti-aquaporin-4 antibody is involved in the pathogenesis of NMO: a study on antibody titre","volume":"130","author":"Takahashi","year":"2007","journal-title":"Brain"},{"key":"R8-20230929","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1002\/ana.20770","article-title":"Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis","volume":"59","author":"Weinshenker","year":"2006","journal-title":"Ann Neurol"},{"key":"R9-20230929","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jns.2010.07.011","article-title":"Frequency and prognostic impact of antibodies to aquaporin-4 in patients with optic neuritis","volume":"298","author":"Jarius","year":"2010","journal-title":"J Neurol Sci"}],"container-title":["The Neurologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00127893-201611000-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T09:38:21Z","timestamp":1695980301000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00127893-201611000-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":9,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1097\/nrl.0000000000000095","relation":{},"ISSN":["1074-7931"],"issn-type":[{"value":"1074-7931","type":"print"}],"subject":[],"published":{"date-parts":[[2016,11]]}}}