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Hamidi BL, Mirawati DK, Rahayu RF, Prabaningtyas HR, Hafizhan M, Putra SE. Chronic inflammatory demyelinating polyradiculoneuropathy associated with neuromyelitis optica spectrum disorder: A rare case report. Prev Med Rep 2024; 42:102702. [PMID: 38737449 PMCID: PMC11081793 DOI: 10.1016/j.pmedr.2024.102702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/19/2024] [Accepted: 03/23/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare disease that targets the myelin sheath, while neuromyelitis optica spectrum disorder (NMOSD) with anti-aquaporin-4 antibodies (AQP4-Ab) affects astrocytes. We report a unique case of CIDP associated with NMOSD. Case presentation A 49-year-old woman presented to the emergency department with recurrent episodes of vertigo and blurred vision. Brain magnetic resonance imaging (MRI) with contrast eight months before admission showed Dawson's finger, and follow-up brain MRI showed a new hyperintense lesion. Visual evoked potential showed bilateral pre-chiasma lesions, and somatosensory evoked potential indicated lesions between the medulla and cerebral cortex. The patient tested positive for AQP4-Ab, and had ascending lower motor neuron weakness for the past 10 weeks. Electromyography revealed multiple demyelinating lesions suggestive of CIDP. The patient was intravenously administered corticosteroids, methotrexate, and azathioprine, resulting in clinical improvement. Conclusion CIDP associated with NMOSD is a rare occurrence. In our patient, a combination of corticosteroids and immunosuppressants was effective. The mechanism of combined demyelination of the central and peripheral nervous systems is still not fully understood, and further immunological and pathological studies are needed.
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Affiliation(s)
- Baarid Luqman Hamidi
- Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
- Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
- Dr. Moewardi General Hospital, Kolonel Sutarto 132 St, Jebres, Kec. Jebres, Kota Surakarta, Central Java 57126, Indonesia
| | - Diah Kurnia Mirawati
- Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
- Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
| | - Rachmi Fauziah Rahayu
- Department of Radiology, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
- Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
| | - Hanindia Riani Prabaningtyas
- Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
| | - Muhammad Hafizhan
- Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
| | - Stefanus Erdana Putra
- Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret Ir. Sutami Street No. 36, Kentingan, Jebres, Surakarta, Central Java 57126, Indonesia
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Chen L, Zhang Y, Qin N, Han R, Li Y. Atypical chronic inflammatory demyelinating polyradiculoneuropathy with ophthalmoplegia and anti-sulfatide IgM positivity. J Int Med Res 2023; 51:3000605231193575. [PMID: 37812511 PMCID: PMC10563483 DOI: 10.1177/03000605231193575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/17/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a heterogeneous group of chronic immune-mediated polyradiculoneuropathies. The clinical presentation of CIDP is mainly characterized by a classic peripheral demyelinating sensory-motor type and persists for a minimum of 2 months. However, CIDP may also present with atypical symptoms.Case presentation: This report presents the case of a patient with CIDP with ophthalmoplegia and anti-sulfatide IgM antibodies. Maintenance intravenous immunoglobulin and glucocorticoid therapies were administered to the patient in accordance with the clinical, laboratory, and electrophysiological findings, which were indicative of CIDP. The treatment partially improved the symptoms, and no recurrence was detected throughout the 3-month monitoring phase. CONCLUSIONS This study combines a retrospective analysis and a literature review to explore the possible mechanism of CIDP.
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Affiliation(s)
- Li Chen
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yanjun Zhang
- Department of Neurology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Nan Qin
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Ranran Han
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuwang Li
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
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He M, Yang F, Wu L, Yin Z, Chen Z, Cheng H, Huang D, Dong Z, Zhang J, Huang X, Yu S. Lower motor neuron involvement in patients with neuromyelitis optica spectrum disorders. Mult Scler Relat Disord 2022; 59:103544. [DOI: 10.1016/j.msard.2022.103544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
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Bitirgen G, Akpinar Z, Uca AU, Ozkagnici A, Petropoulos IN, Malik RA. Progressive Loss of Corneal and Retinal Nerve Fibers in Patients With Multiple Sclerosis: A 2-Year Follow-up Study. Transl Vis Sci Technol 2020; 9:37. [PMID: 33384891 PMCID: PMC7757607 DOI: 10.1167/tvst.9.13.37] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/08/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine longitudinal alterations in corneal nerve fiber morphology, dendritic cell (DC) density, and retinal nerve fiber layer (RNFL) thickness over 2 years in patients with multiple sclerosis (MS). Methods Thirty-one consecutive patients with relapsing-remitting MS (RRMS) underwent assessment of the Kurtzke Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS), corneal confocal microscopy to quantify corneal subbasal nerve morphology and DC density, and spectral-domain optical coherence tomography to quantify RNFL thickness at baseline and after 2 years. Results There was a significant reduction in corneal nerve fiber area (CNFA) (P = 0.003), nerve fiber width (CNFW) (P = 0.005), and RNFL thickness (P = 0.004) with an increase in EDSS (P = 0.01) over 2 years. The change in corneal nerve fiber density (CNFD) correlated with the change in EDSS (ρ = -0.468; P = 0.008), MSSS (ρ = -0.442; P = 0.01), DC density (ρ = -0.550; P = 0.001), and RNFL (ρ = 0.472; P = 0.007). The change in corneal nerve fiber length (CNFL) correlated with the change in EDSS (ρ = -0.445; P = 0.01) and MSSS (ρ = -0.490; P = 0.005). Furthermore, there was a significant decrease in CNFL (P < 0.001), CNFA (P = 0.02), CNFW (P = 0.04), corneal total branch density (P = 0.01), and RNFL thickness (P = 0.02) and a significant increase in DC density (P = 0.04) in patients with worsening EDSS (n = 15). Conclusions Corneal confocal microscopy can be used to detect progressive corneal nerve fiber loss that relates to a progression of disability in patients with RRMS. Translational Relevance Corneal confocal microscopy acts as a sensitive imaging biomarker for progressive nerve degeneration in patients with MS.
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Affiliation(s)
- Gulfidan Bitirgen
- Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Zehra Akpinar
- Department of Neurology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ali Ulvi Uca
- Department of Neurology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ahmet Ozkagnici
- Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | | | - Rayaz A Malik
- Weill Cornell Medicine-Qatar, Research Division, Qatar Foundation, Doha, Qatar.,Institute of Cardiovascular Sciences, Cardiac Centre, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
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5
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Toru S, Soejima I, Katayama Y, Saito K, Yokote H. A case of anti-AQP4 antibody–positive neuromyelitis optica spectrum disorder with MRI-proven lesions in lumbar nerve roots. Mult Scler Relat Disord 2020; 46:102557. [DOI: 10.1016/j.msard.2020.102557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022]
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Asseyer S, Cooper G, Paul F. Pain in NMOSD and MOGAD: A Systematic Literature Review of Pathophysiology, Symptoms, and Current Treatment Strategies. Front Neurol 2020; 11:778. [PMID: 33473247 PMCID: PMC7812141 DOI: 10.3389/fneur.2020.00778] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022] Open
Abstract
Neuromyelitis optica spectrum disorders (NMOSDs) and myelin oligodendrocyte glycoprotein-antibody-associated disease (MOGAD) are autoimmune inflammatory disorders of the central nervous system (CNS). Pain is highly prevalent and debilitating in NMOSD and MOGAD with a severe impact on quality of life, and there is a critical need for further studies to successfully treat and manage pain in these rare disorders. In NMOSD, pain has a prevalence of over 80%, and pain syndromes include neuropathic, nociceptive, and mixed pain, which can emerge in acute relapse or become chronic during the disease course. The impact of pain in MOGAD has only recently received increased attention, with an estimated prevalence of over 70%. These patients typically experience not only severe headache, retrobulbar pain, and/or pain on eye movement in optic neuritis but also neuropathic and nociceptive pain. Given the high relevance of pain in MOGAD and NMOSD, this article provides a systematic review of the current literature pertaining to pain in both disorders, focusing on the etiology of their respective pain syndromes and their pathophysiological background. Acknowledging the challenge and complexity of diagnosing pain, we also provide a mechanism-based classification of NMOSD- and MOGAD-related pain syndromes and summarize current treatment strategies.
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Affiliation(s)
- Susanna Asseyer
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
- NeuroCure Clinical Research Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
| | - Graham Cooper
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
- NeuroCure Clinical Research Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
- Einstein Center for Neurosciences, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
- NeuroCure Clinical Research Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
- Einstein Center for Neurosciences, Berlin, Germany
- Department of Neurology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt—Universität zu Berlin, Berlin, Germany
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Yin H, Nair KP, Rao DG, Hariharan S, Spencer A, Baster K. Upper limb entrapment neuropathies in multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217320930774. [PMID: 32577297 PMCID: PMC7288819 DOI: 10.1177/2055217320930774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/09/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Entrapment neuropathies of upper limbs such as carpal tunnel and cubital tunnel syndromes are common in the general population. Identification of entrapment neuropathies of upper limbs in patients with multiple sclerosis can be clinically challenging as signs and symptoms could be attributed to multiple sclerosis. People at later stages of multiple sclerosis use mobility aids and wheelchairs. Weakness of hands in this cohort due to entrapment neuropathies could adversely affect their mobility and independence. Methods This was a retrospective review of records of patients with multiple sclerosis referred for clinical neurophysiological studies with clinical suspicion of upper limb entrapment neuropathies over a 10-year period. We collected demographic details, clinical features, clinical neurophysiological data and details of aids and appliances used for mobility. Results Among 71 patients, 38 (53.5%) patients had at least one entrapment neuropathy of upper limb confirmed by clinical neurophysiological studies. Twelve (31%) patients had median nerve entrapment, 20 (53%) had ulnar nerve entrapment and six (16%) had both. Risk of ulnar nerve entrapment was significantly higher in patients using a powered wheelchair (odds ratio 5.7, 95% confidence interval (1.7-18.7, p = 0.0037). Discussion Entrapment neuropathies should be considered in patients with multiple sclerosis reporting sensory and motor symptoms of hands.
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Affiliation(s)
- Han Yin
- Northern General Hospital, Sheffield Teaching Hospital NHS Foundation Trust, UK
| | | | | | | | - Amy Spencer
- Statistical Services Unit, University of Sheffield, UK
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8
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Dahan A, Brilot F, Leventer R, Kornberg AJ, Dale RC, Yiu EM. Neuromyelitis Optica Spectrum Disorder and Anti-Aquaporin 4 Channel Immunoglobulin in an Australian Pediatric Demyelination Cohort. J Child Neurol 2020; 35:291-296. [PMID: 31896291 DOI: 10.1177/0883073819895191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Neuromyelitis optica spectrum disorder is uncommon in children, and often seronegative for aquaporin-4 immunoglobulin G (AQP4-IgG). We conducted a retrospective study of 67 children presenting to a single Australian center with acquired demyelinating syndromes over a 7-year period. All patients were tested for AQP4-IgG. Five children (7.5%) had neuromyelitis optica spectrum disorder. One child was seropositive for AQP4-IgG (1.5%) and had a relapsing disease course with mild residual deficits. She also had a concomitant motor axonal neuropathy that improved with immunosuppressive therapy. Of the remaining 4 children, 3 had a monophasic course and 1 a relapsing course. Two were tested for anti-myelin oligodendrocyte glycoprotein (anti-MOG) antibody and both were seropositive. This study confirms that neuromyelitis optica spectrum disorder is uncommon in children, and that AQP4-IgG seropositivity is rare. Anti-MOG antibodies should be tested in children with neuromyelitis optica spectrum disorder.
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Affiliation(s)
- Ariel Dahan
- Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
| | - Fabienne Brilot
- Kids Neuroscience Centre, Children's Hospital Westmead, Westmead, New South Wales, Australia
| | - Richard Leventer
- Department of Neurology, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Neurosciences Research, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Andrew J Kornberg
- Department of Neurology, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Neurosciences Research, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Russell C Dale
- Kids Neuroscience Centre, Children's Hospital Westmead, Westmead, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Eppie M Yiu
- Department of Neurology, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Neurosciences Research, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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Yalachkov Y, Uhlmann V, Bergmann J, Soydaş D, Frisch S, Behrens M, Foerch C, Gehrig J. Patients with chronic autoimmune demyelinating polyneuropathies exhibit cognitive deficits which might be associated with CSF evidence of blood-brain barrier disturbance. PLoS One 2020; 15:e0228679. [PMID: 32017808 PMCID: PMC6999893 DOI: 10.1371/journal.pone.0228679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background Chronic autoimmune demyelinating polyneuropathies (CADP) result in impaired sensorimotor function. However, anecdotal clinical observations suggest the development of cognitive deficits during the course of disease. Methods We tested 16 patients with CADP (11 patients with chronic inflammatory demyelinating polyneuropathy, 4 patients with multifocal motor neuropathy and 1 patient with multifocal acquired demyelinating sensory and motor neuropathy) and 40 healthy controls (HC) with a neuropsychological test battery. Blood-brain-barrier dysfunction (BBBd) in patients was assessed retrospectively by analysing the cerebral spinal fluid (CSF) status at the time the diagnosis of CAPD was established. Results CADP patients failed on average in 1.7 out of 9 neuropsychological tests (SD ± 1.25, min. 0, max. 5). 50% of the CADP patients failed in at least two neuropsychological tests and 44.3% of the patients failed in at least two different cognitive domains. CADP patients exhibiting BBBd at the time of first diagnosis failed in more neuropsychological tests than patients with intact integrity of the BBB (p < 0.05). When compared directly with the HC group, CADP patients performed worse than HC in tests measuring information processing ability and speed as well as phonemic verbal fluency after adjusting for confounding covariates. Conclusions Our results suggest that mild to moderate cognitive deficits might be present in patients with CAPD. One possible tentative explanation, albeit strong evidence is still lacking for this pathophysiological mechanism, refers to the effect of autoimmune antibodies entering the CNS via the dysfunctional blood-brain barrier typically seen in some of the CADP patients.
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Affiliation(s)
- Yavor Yalachkov
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
- * E-mail:
| | - Valerie Uhlmann
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
| | - Johannes Bergmann
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
| | - Dilara Soydaş
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
| | - Stefan Frisch
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
- Institute of Psychology, Goethe-University, Frankfurt am Main, Germany
| | - Marion Behrens
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
| | - Christian Foerch
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
| | - Johannes Gehrig
- University Hospital Frankfurt, Department of Neurology, Frankfurt am Main, Germany
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Cobo-Calvo A, Ayrignac X, Kerschen P, Horellou P, Cotton F, Labauge P, Vukusic S, Deiva K, Serguera C, Marignier R. Cranial nerve involvement in patients with MOG antibody-associated disease. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2019; 6:e543. [PMID: 30800725 PMCID: PMC6384017 DOI: 10.1212/nxi.0000000000000543] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/07/2018] [Indexed: 12/16/2022]
Abstract
Objective To describe clinical and radiologic features of cranial nerve (CN) involvement in patients with myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) and to assess the potential underlying mechanism of CN involvement using a nonhuman primate (NHP) model. Methods Epidemiologic, clinical, and radiologic features from a national cohort of 273 MOG-IgG–positive patients were retrospectively reviewed for CN involvement between January 2014 and January 2018. MOG-IgG binding was evaluated in CNS, CN, and peripheral nerve tissues from NHP. Results We identified 3 MOG-IgG–positive patients with radiologic and/or clinical CN involvement. Two patients displayed either trigeminal or vestibulocochlear nerve lesions at the root level, and the remaining patient had an oculomotor nerve involvement at the root exit and at the cisternal level. Additional CNS involvement was found in all 3 patients. None of the 3 patients' sera recognized MOG expression in CN of NHP. Conclusion Craneal nerve involvement can coexist in patients with MOG antibody disease, although the underlying pathophysiology remains elusive.
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Affiliation(s)
- Alvaro Cobo-Calvo
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Xavier Ayrignac
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Philippe Kerschen
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Philippe Horellou
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Francois Cotton
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Pierre Labauge
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Sandra Vukusic
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Kumaran Deiva
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Ché Serguera
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
| | - Romain Marignier
- Service de neurologie (A.C.-C., S.V., R.M.), sclérose en plaques, pathologies de la myéline et neuroinflammation and Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)- Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, France; Lyon Neuroscience Research Center (A.C.-C., R.M.), U1028 INSERM, UMR5292 CNRS, FLUID Team, Lyon, France; Service de sclérose en plaques (X.A., P.L.), Hôpital Universitaire de Montpellier, France; Service de Neurologie (P.K.), Centre hospitalier de Luxembourg; Inserm (P.H.), U 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Université Paris-Sud 11, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, Faculté de médecine, Le Kremlin-Bicêtre Cedex, France; Service de Radiologie (F.C.), Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Université Claude Bernard Lyon 1 (F.C., S.V., R.M.), F-69100 Villeurbanne, France; Lyon's Neuroscience Research Center (S.V.), Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France; Service de neurologie pédiatrique (K.D.), Centre de référence pour les maladies inflammatoires rares du cerveau et de la moelle, Le Kremlin-Bicêtre, France; and INSERM US27 MIRCen (C.S.), CEA, Fontenay-aux-Roses, France
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11
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Shahmohammadi S, Doosti R, Shahmohammadi A, Mohammadianinejad SE, Sahraian MA, Azimi AR, Harirchian MH, Asgari N, Naser Moghadasi A. Autoimmune diseases associated with Neuromyelitis Optica Spectrum Disorders: A literature review. Mult Scler Relat Disord 2018; 27:350-363. [PMID: 30476871 DOI: 10.1016/j.msard.2018.11.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Neuromyelitis Optica (NMO) is an autoimmune inflammatory demyelinating disease of the central nervous system (CNS) which predominantly involves optic nerves and spinal cord. Since the introduction of Neuromyelitis Optica Spectrum Disorders (NMOSD) as a separate entity, there have been many reports on its association with other disorders including systemic and organ-specific autoimmune diseases. Here, we reviewed other immune-mediated diseases associated with NMOSD and tried to categorize them. METHODS The present review was conducted using the PUBMED database based on papers from 1976 (i.e., since the first NMO comorbidity with SLE was reported) to 2017. We included all articles published in English. The keywords utilized included Neuromyelitis optica, Neuromyelitis Optica Spectrum Disorders, Devic's disease, in combination with comorbidity or comorbidities. RESULTS Diseases with immune-based pathogenesis are the most frequently reported co-morbidities associated with NMOSD, most of which are antibody-mediated diseases. According to literature, Sjogren's Syndrome (SS) and Systemic Lupus Erythematosus (SLE) are the most frequently reported diseases associated with NMOSD among systemic autoimmune diseases. Further, myasthenia gravis in neurological and autoimmune thyroid diseases in non-neurological organ-specific autoimmune diseases are the most reported comorbidities associated with NMOSD in the literature. CONCLUSIONS NMOSD may be associated with a variety of different types of autoimmune diseases. Therefore, systemic or laboratory signs which are not typical for NMOSD should be properly investigated to exclude other associated comorbidities. These comorbidities may affect the treatment strategy and may improve the patients' care and management.
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Affiliation(s)
- Sareh Shahmohammadi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozita Doosti
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abootorab Shahmohammadi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Azimi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Harirchian
- Iranian center for neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Asgari
- Owens-gruppen Næstved/Slagelse/Ringsted Sygehuse, Region Sjælland J.B. Winsløws Vej 9, indgang B, 1. Sal 5000, Odense C, Denmark
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12
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Hu B, Zhou Y, Lu X, Xiong Q, Liu Q, Qi X, Ding W. Chronic inflammatory demyelinating polyradiculoneuropathy: A case report. Medicine (Baltimore) 2018; 97:e12469. [PMID: 30313036 PMCID: PMC6203576 DOI: 10.1097/md.0000000000012469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a disorder characterized by a symmetrical, sensorimotor involvement and slowly progressive onset peripheral neuropathy. Peripheral neuropathies have been reported in some central demyelination patients. However, the central nervous system focus in the CIDP patient can mimic neuromyelitis optica have not been recognized by most of us. PATIENT CONCERNS The numbness and weakness of limbs about eight weeks. DIAGNOSES Chronic inflammatory demyelinating polyradiculoneuropathy. INTERVENTIONS Immunotherapy with intravenous immunoglobulins was applied to this patient. OUTCOMES After 1 year follow-up, the results showed there was still slight numbness of all limbs, and he could walk slowly without help. Gastrocnemius muscle atrophy did not aggravate. LESSONS So It is suggest that CIDP can combine with central lesions mimicking neuromyelitis optica. We should take the diagnosis of CIDP into consideration when we find focus in central nervous system.
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Affiliation(s)
- Bolin Hu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University
| | - Yibiao Zhou
- Department of Orthopaedics, The First Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi Sheng, China
| | - Xiaoqing Lu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University
| | - Qianqian Xiong
- Department of Neurology, The Second Affiliated Hospital of Nanchang University
| | - Qing Liu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University
| | - Xueliang Qi
- Department of Neurology, The Second Affiliated Hospital of Nanchang University
| | - Weijiang Ding
- Department of Neurology, The Second Affiliated Hospital of Nanchang University
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13
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Chi LM, Gao Y, Nan GX. A case report of neuromyelitis optica spectrum disorder with peripheral neuropathy as the first episode. Medicine (Baltimore) 2018; 97:e0059. [PMID: 29517664 PMCID: PMC5882453 DOI: 10.1097/md.0000000000010059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Neuromyelitis optica spectrum disorders (NMOSDs) represent recurrent autoimmune diseases, generally beginning with optic nerve neuritis or acute transverse myelitis. PATIENT CONCERNS A 57-year-old male with long-term alcohol intake was hospitalized because of limb numbness. EMG examination showed the peripheral sensory nerve was in demyelination and an axonal injury was found. His symptoms could not be improved by vitamin B injection but were later significantly attenuated by dexamethasone treatment. Four months later, symptoms of optic neuritis in the left eye appeared, and 6 months later he exhibited peripheral neuropathy with acute myelitis. DIAGNOSES He was diagnosed NMOSD. OUTCOMES Immunotherapy improved his peripheral neuropathy and myelitis symptoms. LESSONS NMOSD patients could represent peripheral neuropathy as the first episode.
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14
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Wang YQ, Chen H, Zhuang WP, Li HL. The clinical features of combined central and peripheral demyelination in Chinese patients. J Neuroimmunol 2018; 317:32-36. [PMID: 29501083 DOI: 10.1016/j.jneuroim.2018.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/30/2017] [Accepted: 02/05/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Combined central and peripheral demyelination (CCPD) is rare and has never been reported as a spectrum disease in Han Chinese population. OBJECTIVES To study the clinical features of CCPD in Han Chinese patients. METHODS Twenty-two CCPD patients were selected from 788 demyelination cases. We reviewed and compared the clinical manifestation, laboratory data, electrophysiological examination, MRI and the prognosis. RESULTS CCPD patients presented with sensory disturbance (86.4%), plegia (77.3%), cranial nerve involvement (77.3%), abnormal deep tendon reflexes (72.7%). CSF data showed increased CSF protein in 81% patients. Oligoclonal IgG bands (OB) were negative. Cortical or juxtacortical, periventricular, infratentorial lesions, thoracic and cervical spinal cord were mostly affected. Visual evoked potentials indicated optic nerves demyelinating in 50% cases. 21 CCPD patients were treated with intravenous immunoglobulin or steroids or both of them, and the efficacy was 33.3%, 54.5%, 71.4%, respectively. One case that showed no response to steroids plus intravenous immunoglobulin treatment was improved significantly after using cyclophosphamide. CONCLUSIONS CCPD is a spectrum disease that can't be regarded as a simple combination of MS and CIDP. A suspected CCPD should receive brain and spinal MRI as well as electrophysiological examination to obtain a precise diagnosis.
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Affiliation(s)
- Yan-Qin Wang
- Fuqing Hospital of Fujian Province, The Affiliated Fuqing Hospital to Fujian Health College, China
| | - Han Chen
- Fuqing Hospital of Fujian Province, The Affiliated Fuqing Hospital to Fujian Health College, China
| | - Wu-Ping Zhuang
- Fuqing Hospital of Fujian Province, The Affiliated Fuqing Hospital to Fujian Health College, China
| | - Hong-Lei Li
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Medical Neurobiology, Zhejiang Province, Hangzhou, China.
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15
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Radiculopathy in neuromyelitis optica. How does anti-AQP4 Ab involve PNS? Mult Scler Relat Disord 2017; 18:77-81. [DOI: 10.1016/j.msard.2017.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/25/2017] [Accepted: 09/10/2017] [Indexed: 12/17/2022]
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16
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Đorđević G, Stamenović J. DEMYELINATION OF THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM: A CASE REPORT. ACTA MEDICA MEDIANAE 2017. [DOI: 10.5633/amm.2017.0106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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López Pardo P, Jiménez Rojas C, Moral Carretón M. Neuromyelitis optica and tactile and visual hallucinations in an elderly patient. Age Ageing 2017; 46:156-157. [PMID: 28181643 DOI: 10.1093/ageing/afw170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/12/2016] [Indexed: 11/12/2022] Open
Abstract
Although neuromyelitis optica initially described by Eugen Devic in 1897 was considered for many years as a variant of multiple sclerosis, clinical course, more aggressive from the start, progressive towards severe disability and poor visual prognosis, and a different response to treatment, clearly point to a different process. Anti-aquaporin 4 antibodies are a specific biomarker of the entity and, since their discovery, both the number of symptoms and the radiological data about the disease have progressively increased, and the concept of clinical spectrum of neuromyelitis optica has been defined.
To our knowledge it is the first reported case of encephalopathy and neuromyelitis optica in elderly patient.
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Affiliation(s)
- Patricia López Pardo
- Geriatric Medicine Section, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | | | - María Moral Carretón
- Palliative Care Unit, Hospital Universitario de Móstoles, Móstoles , Madrid, Spain
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18
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Kim S, Kwon B, Park J, Lee H, Kim H, Park D, Nam K. Neuromyelitis Optica Masquerading as Lumbosacral Radiculopathy: A Case Report. Ann Rehabil Med 2016; 40:943-948. [PMID: 27847726 PMCID: PMC5108723 DOI: 10.5535/arm.2016.40.5.943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/04/2016] [Indexed: 01/05/2023] Open
Abstract
Neuromyelitis optica spectrum disorders (NMOSD) is a demyelinating syndrome of the central nervous system. This case report describes a 31-year-old woman whose electromyography revealed radiculopathy in the left L5-S1 spinal segment without anatomical abnormalities on lumbosacral magnetic resonance imaging (MRI). She was diagnosed with NMOSD based on gadolinium contrast whole spine and brain MRI and anti-aquaporin-4 antibody findings. Her peripheral nervous system might have been damaged during the early course of NMOSD. Therefore, it is necessary to consider NMOSD for patients who have radiculopathy in electromyography if lumbosacral MRI shows no abnormalities.
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Affiliation(s)
- Seungyeon Kim
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Bumsun Kwon
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Jinwoo Park
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Hojun Lee
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Hyojun Kim
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Dayun Park
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Kiyeun Nam
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
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19
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Feyissa AM, Shanina E, Shah R, Smith RG. Neuromyelitis optica phenotype associated with therapy-responsive acute peripheral neuropathy. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2015; 2:e83. [PMID: 25798448 PMCID: PMC4360793 DOI: 10.1212/nxi.0000000000000083] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/20/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Anteneh M Feyissa
- Department of Neurology (A.M.F.), Mayo Clinic, Rochester, MN; and Department of Neurology (E.S., R.S., R.G.S.), University of Texas Medical Branch at Galveston, Galveston, TX
| | - Elena Shanina
- Department of Neurology (A.M.F.), Mayo Clinic, Rochester, MN; and Department of Neurology (E.S., R.S., R.G.S.), University of Texas Medical Branch at Galveston, Galveston, TX
| | - Rahul Shah
- Department of Neurology (A.M.F.), Mayo Clinic, Rochester, MN; and Department of Neurology (E.S., R.S., R.G.S.), University of Texas Medical Branch at Galveston, Galveston, TX
| | - Robert G Smith
- Department of Neurology (A.M.F.), Mayo Clinic, Rochester, MN; and Department of Neurology (E.S., R.S., R.G.S.), University of Texas Medical Branch at Galveston, Galveston, TX
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20
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Zhang H, Verkman AS. Longitudinally extensive NMO spinal cord pathology produced by passive transfer of NMO-IgG in mice lacking complement inhibitor CD59. J Autoimmun 2014; 53:67-77. [PMID: 24698947 DOI: 10.1016/j.jaut.2014.02.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 02/21/2014] [Accepted: 02/26/2014] [Indexed: 12/18/2022]
Abstract
Spinal cord pathology with inflammatory, demyelinating lesions spanning three or more vertebral segments is a characteristic feature of neuromyelitis optica (NMO). NMO pathogenesis is thought to involve binding of immunoglobulin G anti-aquaporin-4 autoantibodies (NMO-IgG) to astrocytes, causing complement-dependent cytotoxicity (CDC) and secondary inflammation, demyelination and neuron loss. We investigated the involvement of CD59, a glycophosphoinositol (GPI)-anchored membrane protein on astrocytes that inhibits formation of the terminal C5b-9 membrane attack complex. CD59 inhibition by a neutralizing monoclonal antibody greatly increased NMO-IgG-dependent CDC in murine astrocyte cultures and ex vivo spinal cord slice cultures. Greatly increased NMO pathology was also found in spinal cord slice cultures from CD59 knockout mice, and in vivo following intracerebral injection of NMO-IgG and human complement. Intrathecal injection (at L5-L6) of small amounts of NMO-IgG and human complement in CD59-deficient mice produced robust, longitudinally extensive white matter lesions in lumbar spinal cord. Pathology was most severe at day 2 after injection, showing loss of AQP4 and GFAP, C5b-9 deposition, microglial activation, granulocyte infiltration, and demyelination. Hind limb motor function was remarkably impaired as well. There was partial remyelination and recovery of motor function by day 5. Our results implicate CD59 as an important modulator of the immune response in NMO, and provide a novel animal model of NMO that closely recapitulates human NMO pathology. Up-regulation of CD59 on astrocytes may have therapeutic benefit in NMO.
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Affiliation(s)
- Hua Zhang
- Department of Medicine, University of California, San Francisco, CA, USA; Department of Physiology, University of California, San Francisco, CA, USA
| | - A S Verkman
- Department of Medicine, University of California, San Francisco, CA, USA; Department of Physiology, University of California, San Francisco, CA, USA.
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