Anorexia heralding the onset of neuromyelitis optica

Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system (CNS) that prefer-entially affects the optic nerves and spinal cord. An autoantibody (NMO-IgG) targeting the aquaporin-4 water channel distinguishes NMO from other inflammatory disorders of the CNS. Recent studies have demonstrated that the area postrema and other circumventricular organs (CVOs) can be targeted in NMO.We herein report the case of a 12-year-old girl who experienced anorexia six months before the onset of NMO. Anorexia caused by hypothalamic or CVO dysfunction may herald the onset of NMO. © 2013 The Japanese Society of Internal Medicine.