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Suspicion of other autoimmune disease prompted an immunological workup, which showed a positive Schirmer\u2019s test and a positive anti-nuclear antibody (ANA) antibody test, disclosing Sj\u00f6gren\u2019s syndrome. Lack of improvement in muscle power with corticosteroids despite reduction in muscle enzymes led to an MRI of the spine, which showed longitudinal extensive transverse myelitis and involvement of the intracranial segment of the right optic nerve. These findings, along with a positive test for aquaporin-4 antibodies, confirmed NMOSD. Treatment with cyclophosphamide led to improvement in muscle power to grade 4 at discharge.<\/jats:p>","DOI":"10.1136\/bcr-2022-249102","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T11:12:02Z","timestamp":1654600322000},"page":"e249102","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Multiple autoimmune disorders in a patient with neuromyelitis optica spectrum disorder presenting with rhabdomyolysis"],"prefix":"10.1136","volume":"15","author":[{"given":"Nalin","family":"Sharma","sequence":"first","affiliation":[{"name":"Internal Medicine, PGIMER, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aman","family":"Sharma","sequence":"additional","affiliation":[{"name":"Internal Medicine (Rheumatology Unit), PGIMER, Chandigarh, 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