Elderly-Onset Neuromyelitis Optica which Developed after the Diagnosis of Prostate Adenocarcinoma and Relapsed after a 23-Valent Pneumococcal Polysaccharide Vaccination

被引:21
作者
Kitazawa, Yu [1 ]
Warabi, Yoko [1 ]
Bandoh, Mitsuaki [1 ]
Takahashi, Toshiyuki [2 ,3 ]
Matsubara, Shiro [1 ]
机构
[1] Tokyo Metropolitan Neurol Hosp, Dept Neurol, Tokyo, Japan
[2] Tohoku Univ, Grad Sch Med, Dept Neurol, Sendai, Miyagi 980, Japan
[3] Natl Yonezawa Hosp, Dept Neurol, Yonezawa, Yamagata, Japan
关键词
neuromyelitis optica; multiple sclerosis; CD4-positive T cells; complement; anti-aquaporin-4; antibody; paraneoplastic syndrome; RANDOMIZED-TRIAL; MULTIPLE-SCLEROSIS; ANTIBODY; PNEUMONIA; MICE;
D O I
10.2169/internalmedicine.51.5636
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:103 / 107
页数:5
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