Sir, We report a 9-yr-old girl with a severe relapsing–remitting course of neuromyelitis optica (NMO) [who had a dramatic and -sustained improvement over a 2-yr period of treatment with mycophenolate mofetil (MMF), the prodrug of mycophenolic acid. A 9-yr-old Caucasian girl, previously healthy, was admitted to A. Meyer Children’s Hospital in November 2001, complaining of motor alterations and headache. Pregnancy and delivery had been uneventful. Psychomotor development was normal. The family medical history was negative for neurological and autoimmune diseases. No recent history of fever, respiratory or gastrointestinal symptoms were recorded. On admission she was alert and afebrile, with respiratory rate and blood pressure within the normal range. She reported pain in her right eye, weakness in both legs and gait difficulties. Routine blood tests were normal, including thyroid function and functional clotting tests. Extensive autoimmune disease work-up resulted negative for systemic lupus erythematosus (SLE), Sj?gren syndrome and antiphospholipid syndrome [4,5]
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