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

来源：

INTERNAL MEDICINE | 2012年 / 51卷 / 01期

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

页码：103 / 107

页数：5

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