Acute Combined Central and Peripheral Demyelination Showing Anti-Aquaporin 4 Antibody Positivity

Kitada, Mari; Suzuki, Hidekazu; Ichihashi, Juri; Inada, Rino; Miyamoto, Katsuichi; Takahashi, Toshiyuki; Mitsui, Yosuke; Fujihara, Kazuo; Kusunoki, Susumu

doi:10.2169/internalmedicine.51.7590

Cited by 26 publications

(22 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kitada et al . reported an HCV-infected patient with simultaneous central and peripheral demyelination in association with anti-AQP4 antibodies and negative systemic autoimmune markers [ 8 ]. The clinical picture improved after sequential treatment with high-dose intravenous steroid and plasma exchange.…”

Section: Neuromyelitis Opticamentioning

confidence: 99%

“…We here review known demyelinating disorders of the central nervous system (CNS) and of the peripheral nervous system (PNS) occurring in association with chronic HCV-infection. We also describe a case of HCV-related neuromyelitis optica (NMO) with circulating anti-aquaporin-4-IgG, an association previously reported in a single patient [ 8 ]. Finally, we call attention to the significantly increased prevalence of demyelinating neuropathy with monoclonal IgM anti-myelin-associated glycoprotein (MAG) antibodies, accounting for 5%, in a consecutive case series of 59 HCV-infected patients, as opposed to the estimated frequency of 0.001-0.005% in the adult population [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

HCV-Related Central and Peripheral Nervous System Demyelinating Disorders

Mariotto¹,

Ferrari²,

Monaco

2015

IADT

View full text Add to dashboard Cite

Chronic infection with hepatitis C virus (HCV) is associated with a large spectrum of extrahepatic manifestations (EHMs), mostly immunologic/rheumatologic in nature owing to B-cell proliferation and clonal expansion. Neurological complications are thought to be immune-mediated or secondary to invasion of neural tissues by HCV, as postulated in transverse myelitis and encephalopathic forms. Primarily axonal neuropathies, including sensorimotor polyneuropathy, large or small fiber sensory neuropathy, motor polyneuropathy, mononeuritis, mononeuritis multiplex, or overlapping syndrome, represent the most common neurological complications of chronic HCV infection. In addition, a number of peripheral demyelinating disorders are encountered, such as chronic inflammatory demyelinating polyneuropathy, the Lewis-Sumner syndrome, and cryoglobulin-associated polyneuropathy with demyelinating features. The spectrum of demyelinating forms also includes rare cases of iatrogenic central and peripheral nervous system disorders, occurring during treatment with pegylated interferon. Herein, we review HCV-related demyelinating conditions, and disclose the novel observation on the significantly increased frequency of chronic demyelinating neuropathy with anti-myelin-associated glycoprotein antibodies in a cohort of 59 consecutive patients recruited at our institution. We also report a second case of neuromyelitis optica with serum IgG autoantibody against the water channel aquaporin-4. The prompt recognition of these atypical and underestimated complications of HCV infection is of crucial importance in deciding which treatment option a patient should be offered.

show abstract

Section: Neuromyelitis Opticamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HCV-Related Central and Peripheral Nervous System Demyelinating Disorders

Mariotto¹,

Ferrari²,

Monaco

2015

IADT

View full text Add to dashboard Cite

show abstract

“…Neuromyelitis optica (NMO) is another inflammatory demyelinating disease of the CNS which is characterized by lesions confined to the optic nerve and spinal cord, especially longitudinally extensive spinal cord lesions [ 4 ], antiaquaporin-4 (AQP-4) autoantibody seropositivity [ 5 ], and astrocytic impairment associated with the loss of AQP-4 in NMO lesions [ 6 ]. There have been limited reports about the characteristics of peripheral neuropathy as a complication of NMO [ 7 , 8 ]. In this paper, we evaluated the electrophysiological changes with nerve conduction studies (NCS) in MS and NMO patients and showed the characteristics and differences between peripheral neuropathy as a complication of MS and NMO.…”

Section: Introductionmentioning

confidence: 99%

Abnormal Nerve Conduction Study Findings Indicating the Existence of Peripheral Neuropathy in Multiple Sclerosis and Neuromyelitis Optica

Warabi

Yamazaki

Shimizu

et al. 2013

BioMed Research International

View full text Add to dashboard Cite

Objective. Chronic inflammatory demyelinating polyneuropathy (CIDP) has been reported in patients with multiple sclerosis (MS). However, there have been limited reports of peripheral neuropathy as a complication of neuromyelitis optica (NMO). In this paper, we showed the characteristics and differences between peripheral neuropathy as a complication of MS and NMO. Method. We analyzed a series of 58 MS and 28 NMO patients and evaluated nerve conduction studies (NCS) in 21 MS and 5 NMO patients. Results. Six of the 58 MS and 3 of the 28 NMO patients revealed abnormal NCS findings. Three (5.2%) of the 58 MS patients fulfilled the criteria for CIDP. One (3.6%) of the 28 NMO patients showed peripheral neuropathy at the same time of NMO relapse, although CIDP was not seen in NMO. The other 5 (3 MS and 2 NMO) patients were complicated with neuropathy caused by concomitant diabetes mellitus and Sjögren's syndrome. Conclusion. Frequency of abnormal NCS findings might exhibit no significant difference between MS and NMO, although the cause and pathophysiology of peripheral neuropathy were different in MS and in NMO. There might be a group of NMO who were affected simultaneously in the central and peripheral nervous tissues.

show abstract

“…In this study, NCS revealed abnormalities of various types and degree in approximately half of the neurologically asymptomatic patients with hepatitis C. Twenty percent of the patients had PN, 23.3% CTS, and 6.6% PN associated with CTS. In the relevant literature, symmetric sensorimotor PN of mostly the axonal type and mononeuropathy multiplex are reported in association with hepatitis C infection (22). However, in patients lacking cryoglobulin, demyelinating PN dominate (23,24).…”

Section: Discussionmentioning

confidence: 99%

Screening for Electrophysiological Abnormalities in Chronic Hepatitis C Infection: Peripheral Neuropathy and Optic Neuropathy

Köşkderelioğlu

Ortan

Arı

et al. 2016

Arch Neuropsychiatr

View full text Add to dashboard Cite

Hepatitis C-related neurological abnormalities may occur both in the central and peripheral nervous system. Mononeuritis multiplex, sensorial axonal neuropathy, and multiple mononeuropathies are some of the presentations of the peripheral nervous system involvement. The mode of infection is considered to be via vasculitic mechanisms. In addition, optic neuropathy is a known complication of interferon treatment. Autoantibodies, cytokines, chemokines, and cryoglobulins are accused to play roles in the pathogenesis. In this study, we investigated the involvement of the peripheral nervous system and optic nerves in a group of patients with hepatitis C. The results were in favor of peripheral nerve injury of various types and optic neuropathy of the axonal type.

show abstract

Acute Combined Central and Peripheral Demyelination Showing Anti-Aquaporin 4 Antibody Positivity

Cited by 26 publications

References 27 publications

HCV-Related Central and Peripheral Nervous System Demyelinating Disorders

HCV-Related Central and Peripheral Nervous System Demyelinating Disorders

Abnormal Nerve Conduction Study Findings Indicating the Existence of Peripheral Neuropathy in Multiple Sclerosis and Neuromyelitis Optica

Screening for Electrophysiological Abnormalities in Chronic Hepatitis C Infection: Peripheral Neuropathy and Optic Neuropathy

Contact Info

Product

Resources

About