Neuromyelitis optica (NMO) is usually a relapsing demyelinating disease of the 
central nervous system associated with optic neuritis, transverse myelitis 
involving three or more contiguous spinal cord segments, and seropositivity for 
NMO-IgG antibody. NMO is often mistaken for multiple sclerosis and there are 
relatively sporadic publications about NMO and overlapping systemic or 
organ-specific autoimmune diseases, such as systemic lupus erythematosus (SLE). 
We described a unique case of a 25-year-old Arab young woman who was diagnosed 
with SLE, depending on clinical, laboratory investigations and after she had 
fulfilled the diagnostic criteria for SLE and had presented the following 
findings: constitutional findings (fatigue, fever, and arthralgia); dermatologic 
finding (photosensitivity and butterfly rash); chronic renal failure 
(proteinuria up to 400 mg in 24 hours); hematologic and antinuclear antibodies 
(positivity for antinuclear factor (ANF), anti-double-stranded DNA antibodies, 
direct Coombs, ANA and anti-DNA, low C4 and C3, aCL by IgG and IgM). Recently, 
she presented with several episodes of transverse myelitis and optic neuritis. 
Clinical, radiological, and laboratory findings especially seropositivity for 
NMO-IgG were compatible with NMO. Accurate diagnosis is critical to facilitate 
initiation of immunosuppressive therapy for attack prevention. This case 
illustrates that NMO may be associated with SLE.