We report a case of elderly-onset neuromyelitis optica (NMO) positive for the anti-aquaporin-4 (AQP-4) antibody; symptoms developed after the diagnosis of prostate adenocarcinoma and relapsed after a 23-valent pneumococcal polysaccharide vaccination. We suggest that activation of CD4-positive T cells and secretion of interferon-gamma induced by adenocarcinoma and complement activation induced by vaccination are responsible for the onset and relapse of NMO, even if a patient is positive for the anti-AQP-4 antibody. This case supports the previous experimental finding that the anti-AQP-4 antibody does not cause NMO-like lesions when injected alone, but does so after the induction of T cell-mediated experimental autoimmune encephalomyelitis or when co-injected with human complement.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2169/internalmedicine.51.5636 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Successful treatment of rituximab-unresponsive elderly-onset neuromyelitis optica spectrum disorder and hypogammaglobulinemia with ofatumumab plus intravenous immunoglobulin therapy in a patient with mutant genotype: A case report.
Front Immunol
December 2022
Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
Background: Elderly-onset neuromyelitis optica spectrum disorder (NMOSD) is a rare entity that poses a therapeutic challenge. We report a case of elderly-onset NMOSD with mutant genotype who was successfully treated with ofatumumab after multiple episodes of relapse.
Case Report: The patient was a 67-year-old woman who was diagnosed with NMOSD with high disease activity.
Elderly onset neuromyelitis optica spectrum disorder: a case report.
J Neurol
December 2021
Neurology Department, Rennes University Hospital, CHU Pontchaillou, Rennes, France.
[Elderly onset case of neuromyelitis optica that developed at the age of 90].
Rinsho Shinkeigaku
December 2018
Department of Neurology, Hiroshima City Asa Citizens Hospital.
We report a case of neuromyelitis optica (NMO) that was diagnosed at the age of 90. After initially developing visual loss in the right eye, a patient was diagnosed with optic neuritis. Although treatment with methylprednisolone therapy provided relief, 3 months later she developed optic neuritis on the other side.
View Article and Find Full Text PDFElderly-Onset Neuromyelitis Optica Spectrum Disorder with Pre-Existing Prednisone Allergy.
Case Rep Neurol
January 2018
Department of Neurology, University of Oklahoma, Oklahoma City, Oklahoma, USA.
We present a case of an 82-year-old man with new-onset neuromyelitis optica (NMO) spectrum disorder, the treatment of which was complicated by a severe pre-existing prednisone allergy. His age caused much initial doubt about his diagnosis, and his corticosteroid allergy altered our management as we attempted to minimize risk to the patient. Our patient was a healthy 82-year-old, right-handed man who presented with sensory loss of the bilateral lower extremities and progressive, painless vision loss.
View Article and Find Full Text PDFProgressive cerebral atrophy in neuromyelitis optica.
Mult Scler
December 2015
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan.
We report two cases of neuromyelitis optica patients with progressive cerebral atrophy. The patients exhibited characteristic clinical features, including elderly onset, secondary progressive tetraparesis and cognitive impairment, abnormally elevated CSF protein and myelin basic protein levels, and extremely highly elevated serum anti-AQP-4 antibody titer. Because neuromyelitis optica pathology cannot switch from an inflammatory phase to the degenerative phase until the terminal phase, neuromyelitis optica rarely appears as a secondary progressive clinical course caused by axonal degeneration.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!