Very late-onset recurrent myelitis in a patient diagnosed with antiphospholipid syndrome: A puzzle of autoimmunity.

We describe the case of a man with a very-late onset neuromyelitis optica spectrum disorder syndrome (NMOSD) who was initially diagnosed as recurrent antiphospholipid syndrome-associated myelitis. This case illustrates that a puzzle of autoreactive antibodies can be detected in patients having neurological syndromes belonging to the NMOSD. Prompt identification and timely immunosuppression prevent relapses and the accumulation of irreversible disability.