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Konstantina G. Yiannopoulou, MD; Athina K. Efthymiou, MD; Kleanthis D. Karydakis, MD

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We were greatly interested in the article by Pittock et al¹ titled "Neuromyelitis Optica and Non–Organ-Specific Autoimmunity." We describe a patient with neuromyelitis optica (NMO) and NMO-IgG seropositivity with coexisting organ-specific (Hashimoto thyroiditis) and tissue-specific (alopecia areata) autoimmune disorders. Our patient, a 30-year-old Greek woman, was admitted to the hospital 3 years ago because she had subacute spastic tetraparesis with a C4 sensory level. Her history was remarkable for polycystic ovarian syndrome, hyperprolactinemia, hypothyroidism due to Hashimoto thyroiditis, and alopecia areata. Eight days later, she developed bilateral optic neuritis. Brain magnetic resonance imaging results were normal. Spinal magnetic resonance imaging showed cavitationlike intramedullary necrotic lesions from C2 to C7 (Figure, A-C). She had elevated serum prolactin (4.21 x 10⁷ µg/L [to convert to picomoles per liter, multiply by 43.478]) and free testosterone (1.71 ng/dL [to convert . . . [Full Text of this Article]

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