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Case of neuromyelitis optica with recurrent stomach carcinoma
Author(s) -
Takewaki Daiki,
Kasai Takashi,
Itoh Kyoko,
Shiga Kensuke,
Tokui Masafumi,
Tanaka Akihiro,
Noto Yuichi,
Ohara Tomoyuki,
Mizuno Toshiki
Publication year - 2017
Publication title -
clinical and experimental neuroimmunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.297
H-Index - 15
ISSN - 1759-1961
DOI - 10.1111/cen3.12417
Subject(s) - neuromyelitis optica , medicine , malignancy , autoimmunity , autoantibody , cancer , optic neuritis , pathology , aquaporin 4 , stomach , myelitis , transverse myelitis , stomach cancer , immunology , multiple sclerosis , antibody , disease , spinal cord , psychiatry
Background Neuromyelitis optica ( NMO ) is an autoimmune astrocytopathy associated with anti‐aquaporin‐4 ( AQP 4). The development of NMO in the setting of cancer suggests that AQP 4 autoimmunity might in some cases be paraneoplastic. Case presentation We report an 85‐year‐old woman who developed a right optic neuritis and a longitudinally extensive transverse myelitis associated with AQP 4 autoantibodies after the relapse of stomach cancer. Histopathological observations in several case reports have led to the hypothesis that the NMO associated with the malignancy is caused by an autoimmunity against abnormally expressed AQP 4 on tumor cells. However, we found no AQP 4 antigen on the cancer cells in our resected tissues. Our findings did not support the concept of a paraneoplastic process in the narrow sense. Conclusions The exact mechanisms of cancer‐related NMO , which might be multifactorial, remain controversial.