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Khaladkar SM, KirdatPatil PP, Dhande A, Jhala NA. Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Complicated by Pachymeningitis: A Case Report. Cureus 2024; 16:e64868. [PMID: 39156322 PMCID: PMC11330373 DOI: 10.7759/cureus.64868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 07/18/2024] [Indexed: 08/20/2024] Open
Abstract
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disorder that primarily affects the central nervous system (CNS). We present a unique case of MOGAD complicated by pachymeningitis, which is characterized by inflammation of the dura mater. The clinical presentation included vertigo, nausea, and vomiting. A diagnostic workup confirmed MOGAD complicated by pachymeningitis. This case underscores the diverse clinical manifestations of MOGAD and highlights the challenges in diagnosis and management, particularly when complicated by rare manifestations like pachymeningitis.
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Affiliation(s)
- Sanjay M Khaladkar
- Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Prajakta P KirdatPatil
- Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Aryaman Dhande
- Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Neeha A Jhala
- Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Biddle G, Beck RT, Raslan O, Ebinu J, Jenner Z, Hamer J, Hacein-Bey L, Apperson M, Ivanovic V. Autoimmune diseases of the spine and spinal cord. Neuroradiol J 2024; 37:285-303. [PMID: 37394950 PMCID: PMC11138326 DOI: 10.1177/19714009231187340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Magnetic resonance imaging (MRI) and clinicopathological tools have led to the identification of a wide spectrum of autoimmune entities that involve the spine. A clearer understanding of the unique imaging features of these disorders, along with their clinical presentations, will prove invaluable to clinicians and potentially limit the need for more invasive procedures such as tissue biopsies. Here, we review various autoimmune diseases affecting the spine and highlight salient imaging features that distinguish them radiologically from other disease entities.
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Affiliation(s)
- Garrick Biddle
- Radiology Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Ryan T Beck
- Neuroradiology, Radiology Department, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Osama Raslan
- Radiology Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Julius Ebinu
- Neurosurgery Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Zach Jenner
- Radiology Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - John Hamer
- Neuroradiology, Radiology Department, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lotfi Hacein-Bey
- Radiology Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Michelle Apperson
- Neurology Department, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Vladimir Ivanovic
- Neuroradiology, Radiology Department, Medical College of Wisconsin, Milwaukee, WI, USA
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Weidauer S, Hattingen E, Arendt CT. Cervical myelitis: a practical approach to its differential diagnosis on MR imaging. ROFO-FORTSCHR RONTG 2023; 195:1081-1096. [PMID: 37479218 DOI: 10.1055/a-2114-1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
BACKGROUND Differential diagnosis of non-compressive cervical myelopathy encompasses a broad spectrum of inflammatory, infectious, vascular, neoplastic, neurodegenerative, and metabolic etiologies. Although the speed of symptom onset and clinical course seem to be specific for certain neurological diseases, lesion pattern on MR imaging is a key player to confirm diagnostic considerations. METHODS The differentiation between acute complete transverse myelitis and acute partial transverse myelitis makes it possible to distinguish between certain entities, with the latter often being the onset of multiple sclerosis. Typical medullary MRI lesion patterns include a) longitudinal extensive transverse myelitis, b) short-range ovoid and peripheral lesions, c) polio-like appearance with involvement of the anterior horns, and d) granulomatous nodular enhancement prototypes. RESULTS AND CONCLUSION Cerebrospinal fluid analysis, blood culture tests, and autoimmune antibody testing are crucial for the correct interpretation of imaging findings. The combination of neuroradiological features and neurological and laboratory findings including cerebrospinal fluid analysis improves diagnostic accuracy. KEY POINTS · The differentiation of medullary lesion patterns, i. e., longitudinal extensive transverse, short ovoid and peripheral, polio-like, and granulomatous nodular, facilitates the diagnosis of myelitis.. · Discrimination of acute complete and acute partial transverse myelitis makes it possible to categorize different entities, with the latter frequently being the overture of multiple sclerosis (MS).. · Neuromyelitis optica spectrum disorders (NMOSD) may start as short transverse myelitis and should not be mistaken for MS.. · The combination of imaging features and neurological and laboratory findings including cerebrospinal fluid analysis improves diagnostic accuracy.. · Additional brain imaging is mandatory in suspected demyelinating, systemic autoimmune, infectious, paraneoplastic, and metabolic diseases..
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Affiliation(s)
- Stefan Weidauer
- Institute for Neuroradiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Elke Hattingen
- Institute for Neuroradiology, Goethe University Frankfurt, Frankfurt am Main, Germany
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Hsu TL, Lee YH, Wang YH, Chang R, Wei JCC. Association of Hallux Valgus with Degenerative Spinal Diseases: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1152. [PMID: 36673906 PMCID: PMC9858771 DOI: 10.3390/ijerph20021152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Background: Although hallux valgus is known to cause lower-back pain, the association between hallux valgus and spinal degenerative disease remains unclear. Methods: A retrospective cohort study was conducted between 1 January 2000 and 31 December 2015 using data from the Longitudinal Health Insurance Database in Taiwan. After propensity score matching for age, sex, and some potential comorbidities, 1000 individuals newly diagnosed with hallux valgus were enrolled in the study group, while 1000 individuals never diagnosed with hallux valgus served as the control group. Both groups were followed up until 2015 to evaluate the incidence of hallux valgus. Kaplan-Meier analysis was used to determine the cumulative incidence of hallux valgus, while the Cox proportional hazard model was adopted to estimate the hazard ratio (HR) and adjusted hazard ratio (aHR) with 95% confidence intervals (CIs). Results: The incidence densities of spinal degeneration in the hallux valgus and non-hallux valgus groups were 73.10 and 42.63 per 1000 person-years, respectively. An increased risk of spinal degenerative changes was associated with hallux valgus (adjusted HR = 1.75, 95% CI = 1.50−2.05). Age- and sex-stratified analyses showed a significantly higher risk of spinal degeneration in the hallux valgus group. Moreover, sub-outcome evaluations revealed significantly higher risks of spondylosis (aHR = 2.01, 95% CI = 1.55−2.61), intervertebral disorder (aHR = 2.27, 95% CI = 1.62−3.17), and spinal stenosis (aHR = 1.24, 95% CI = 1.47−1.76). There was also an increased risk of spinal degenerative change in those with hallux valgus without surgical intervention (aHR = 1.95, 95% CI = 1.66−2.99, p < 0.001). Conclusions: Hallux valgus was associated with increased risk of degenerative spinal changes and other spinal disorders.
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Affiliation(s)
- Ta-Li Hsu
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Yung-Heng Lee
- Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu 304, Taiwan
- Department of Recreation and Sport Management, Shu-Te University, Kaohsiung 824, Taiwan
- Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung 842, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Recreation Sports Management, Tajen University, Pingtung 907, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404, Taiwan
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Wang X, Lu K, Yao X, Zhang L, Wang F, Wu D, Peng J, Chen X, Du J, Wei J, Ma J, Chen L, Zou S, Zhang C, Zhang M, Dong H. The Aquaporin TaPIP2;10 Confers Resistance to Two Fungal Diseases in Wheat. PHYTOPATHOLOGY 2021; 111:2317-2331. [PMID: 34058861 DOI: 10.1094/phyto-02-21-0048-r] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Plants employ aquaporins (AQPs) of the plasma membrane intrinsic protein (PIP) family to import environmental substrates, thereby affecting various processes, such as the cellular responses regulated by the signaling molecule hydrogen peroxide (H2O2). Common wheat (Triticum aestivum) contains 24 candidate members of the PIP family, designated as TaPIP1;1 to TaPIP1;12 and TaPIP2;1 to TaPIP2;12. None of these TaPIP candidates have been characterized for substrate selectivity or defense responses in their source plant. Here, we report that T. aestivum AQP TaPIP2;10 facilitates the cellular uptake of H2O2 to confer resistance against powdery mildew and Fusarium head blight, two devastating fungal diseases in wheat throughout the world. In wheat, the apoplastic H2O2 signal is induced by fungal attack, while TaPIP2;10 is stimulated to translocate this H2O2 into the cytoplasm, where it activates defense responses to restrict further attack. TaPIP2;10-mediated transport of H2O2 is essential for pathogen-associated molecular pattern-triggered plant immunity (PTI). Typical PTI responses are induced by the fungal infection and intensified by overexpression of the TaPIP2;10 gene. TaPIP2;10 overexpression causes a 70% enhancement in wheat resistance to powdery mildew and an 86% enhancement in resistance to Fusarium head blight. By reducing the disease severities, TaPIP2;10 overexpression brings about >37% increase in wheat grain yield. These results verify the feasibility of using an immunity-relevant AQP to concomitantly improve crop productivity and immunity.
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Affiliation(s)
- Xiaobing Wang
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu Province 210095, China
| | - Kai Lu
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
| | - Xiaohui Yao
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
| | - Liyuan Zhang
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
- State Key Laboratory of Crop Biology, Shandong Agricultural University, Taian, Shandong Province 271018, China
| | - Fubin Wang
- Institute of Environmental Sciences & Resources and Plant Protection, Jining Academy of Agricultural Sciences, Jining, Shandon Province 272000, China
| | - Degong Wu
- College of Agriculture, Anhui Science and Technology University, Fengyang, Anhui Province 233100, China
| | - Jinfeng Peng
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu Province 210095, China
| | - Xiaochen Chen
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu Province 210095, China
| | - Junli Du
- College of Agriculture, Anhui Science and Technology University, Fengyang, Anhui Province 233100, China
| | - Jiankun Wei
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
| | - Jingyu Ma
- Institute of Environmental Sciences & Resources and Plant Protection, Jining Academy of Agricultural Sciences, Jining, Shandon Province 272000, China
| | - Lei Chen
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
- State Key Laboratory of Crop Biology, Shandong Agricultural University, Taian, Shandong Province 271018, China
| | - Shenshen Zou
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
- State Key Laboratory of Crop Biology, Shandong Agricultural University, Taian, Shandong Province 271018, China
| | - Chunling Zhang
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu Province 210095, China
| | - Meixiang Zhang
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu Province 210095, China
| | - Hansong Dong
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu Province 210095, China
- College of Plant Protection, Shandong Agricultural University, Taian, Shandong Province 271018, China
- State Key Laboratory of Crop Biology, Shandong Agricultural University, Taian, Shandong Province 271018, China
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Gudkova VV, Kimelfeld EI, Paderina VP, Koshurnikov DS, Ulianov DI, Ermakov DS, Maliutina NA. Opticoneuromyelitis associated with melanoma. Case report. CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.11.201159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This article presents a clinical review of a patient with an extremely rare assotiation of opticoneuromyelitis and skin melanoma. The paper noted the typical clinical and neuroimaging signs of opticoneuromyelitis and the rare manifestations of myelitic syndrome such as segmental muscle hypertonicity and hand hyperkinesis. The question remains open as to whether these two processes in a patient are linked by a single pathogenesis in the form of a paraneoplastic neurological syndrome or whether two independent diseases are represent there. Two observations of a combination of melanoma and opticoneuromyelitis as a manifestation of the paraneoplastic syndrome have been analysed in the literature. The article highlights the difficulties in the treatment of this patient, as the immunomodulatory therapy used for both diseases has a different vectorial focus. Immunosuppression is recommended for the treatment of opticoneuromyelitis, while immune activation is recommended for melanoma.
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