No To Shinkei 2002 Nov;54(11):997-1001
Maeda K, Yamahira M, Murata Y, Uto T, Yasuda H.
Department of Neurology, Shiga University of Medical Science, Tsukinowa-machi, Seta, Otsu-shi, Shiga 520-2192, Japan.
A 21-year-old woman came to the department of ophthalmology because of decreased visual acuity detected at the driving license center.
MRI revealed T 1 iso-, T 2 hyper-intense, and Gd-enhanced lesion in the left optic nerve adjacent to the optic chiasma.
No autoantibodies indicating systemic lupus erythematosus, Sjogren syndrome, or anti-phospholipid syndrome were elevated except for antinuclear antibody.
There were no cerebral and spinal lesions on MRI.
Neither oligoclonal IgG band nor myelin basic protein was found in the cerebrospinal fluid.
Although she did not complain of dry mouth, secretion of the saliva was decreased.
Biopsy of the minor salivary gland showed sialadenitis with infiltration of mononuclear cells, suggesting subclinical Sjogren syndrome.
Visual acuity and MRI findings were remitted spontaneously.
This case is distinguished from multiple sclerosis and vasculitis or ischemic mechanism(s) associated with autoantibodies might play a role in the development of the disease.