AQP4-IgG-positive neuromyelitis optica spectrum disorder and temporally detected neoplasms: case report and systematic review

Apiraksattaykul, Natnasak; Songwisit, Sakdipat; Owattanapanich, Weeraphat; Tisavipat, Nanthaya; Siritho, Sasitorn; Prayoonwiwat, Naraporn; Rattanathamsakul, Natthapon; Jitprapaikulsan, Jiraporn

doi:10.1016/j.msard.2022.104212

Cited by 6 publications

(6 citation statements)

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“…The authors clearly demonstrated the presence of AQP-4 IgG in serum and the expression of AQP-4 in tumor tissue and indicated that this was likely the trigger of an autoimmune response. In 59.7% to 61.0% of all paraneoplastic NMOSD cases, NMOSD-related symptoms either preceded or occurred concurrently with cancer diagnosis, similar to that observed in the present case [ 3 , 16 , 19 ]. The most common initial presentation of paraneoplastic NMOSD was transverse myelitis; however, among patients with central nervous system symptoms, APS accounted for 83.3% [ 3 ].…”

Section: Discussionsupporting

confidence: 87%

“…Although NMOSD is primarily an idiopathic autoimmune disease, it also occurs as a paraneoplastic syndrome in 1.3% to 25% of patients [ 3 , 14 – 16 ]. Those with paraneoplastic NMOSD are generally older at disease onset (mean age, 50–55 years) [ 3 , 14 – 17 ], while the overall median age of onset for NMOSD ranges between 32 and 41 years.…”

Section: Discussionmentioning

confidence: 99%

“…Onconeural antigens expressed on tumors are hypothesized to stimulate the host immune system to produce antibodies such as AQP-4 IgG, which cross-react with nervous tissue and induce damage in the central nervous system. Breast and lung cancers are the 2 most frequent tumors that trigger paraneoplastic NMOSD [ 3 , 14 , 16 , 17 ], and breast cancer accounts for 18.3% to 32% of all paraneoplastic NMODS cases [ 3 , 13 , 16 , 17 ]. Tumor expression of AQP-4 confirmed by immunohistochemical staining is necessary to demonstrate a causal link, and only these cases should be termed paraneoplastic NMOSD [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Breast and lung cancers are the 2 most frequent tumors that trigger paraneoplastic NMOSD [ 3 , 14 , 16 , 17 ], and breast cancer accounts for 18.3% to 32% of all paraneoplastic NMODS cases [ 3 , 13 , 16 , 17 ]. Tumor expression of AQP-4 confirmed by immunohistochemical staining is necessary to demonstrate a causal link, and only these cases should be termed paraneoplastic NMOSD [ 16 ]. To the best of our knowledge, the expression of AQP-4 in breast cancer tissue was demonstrated in only 2 other cases.…”

Section: Discussionmentioning

confidence: 99%

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A 51-Year-Old Woman with Advanced Breast Cancer and a 2-Week History of Nausea and Vomiting Due to Neuromyelitis Optica Spectrum Disorder (NMOSD) and Seropositivity to Aquaporin-4 (AQP-4)

Miyagishima,

Anezaki,

Fukuda

et al. 2023

Am J Case Rep

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Patient: Female, 51-year-old Final Diagnosis: Breast cancer • neuromyelitis optica spectrum disorder Symptoms: Nausea and vomiting Clinical Procedure: — Specialty: Neurology Objective: Rare coexistence of disease or pathology Background: Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating disease of the central nervous system that includes the triad of transverse myelitis, optic neuritis, and area postrema syndrome (APS), characterized by intractable nausea and vomiting. NMOSD can be part of a paraneoplastic syndrome and is associated with seropositivity to aquaporin-4 (AQP-4). We present a patient with uncontrollable nausea and vomiting who developed herpes zoster and acute myelitis and was finally diagnosed with paraneoplastic NMOSD due to breast cancer. Case Report: A 51-year-old woman was hospitalized due to 2 weeks of intractable nausea and vomiting. Although contrast-enhanced thoracoabdominal computed tomography (CT) on day 4 suggested breast cancer in her left breast, the etiology of her symptoms remained unknown. On day 13, she developed herpes zoster, followed by acute myelitis on day 25. Magnetic resonance imaging (MRI) showing longitudinal extensive transverse myelitis and an elevated serum AQP-4 antibody level led to the diagnosis of NMOSD. Brain MRI detected a small lesion in the dorsal medulla oblongata, which explained the preceding APS. After starting intravenous methylpredniso-lone pulse therapy, her nausea and vomiting rapidly subsided. Breast cancer was resected on day 63, and immunohistochemical staining revealed overexpression of AQP-4 in the tumor cells, suggesting paraneoplastic NMOSD. Conclusions: This report has highlighted the presentation and diagnosis of NMOSD and supports the possibility that this can present as part of a paraneoplastic syndrome. In addition, diagnosis of NMOSD preceded by APS requires meticulous history taking and careful interpretation of MRI in the dorsal medulla oblongata.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A 51-Year-Old Woman with Advanced Breast Cancer and a 2-Week History of Nausea and Vomiting Due to Neuromyelitis Optica Spectrum Disorder (NMOSD) and Seropositivity to Aquaporin-4 (AQP-4)

Miyagishima,

Anezaki,

Fukuda

et al. 2023

Am J Case Rep

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“…The following are available online at : Supplementary Material S1: PRISMA 2020 Checklist [ 54 ]; Supplementary Material S2: List of Excluded Studies [ 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ].…”

mentioning

confidence: 99%

Paraneoplastic Syndromes in Neuroendocrine Prostate Cancer: A Systematic Review

Abufaraj,

Ramadan,

Alkhatib

2024

Current Oncology

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Neuroendocrine prostate cancer (NEPC) is a rare subtype of prostate cancer (PCa) that usually results in poor clinical outcomes and may be accompanied by paraneoplastic syndromes (PNS). NEPC is becoming more frequent. It can initially manifest as PNS, complicating diagnosis. Therefore, we reviewed the literature on the different PNS associated with NEPC. We systematically reviewed English-language articles from January 2017 to September 2023, identifying 17 studies meeting PRISMA guidelines for NEPC and associated PNS. A total of 17 articles were included in the review. Among these, Cushing’s Syndrome (CS) due to ectopic Adrenocorticotropic hormone (ACTH) secretion was the most commonly reported PNS. Other PNS included syndrome of inappropriate Anti-Diuretic Hormone secretion (SIADH), Anti-Hu-mediated chronic intestinal pseudo-obstruction (CIPO), limbic encephalitis, Evans Syndrome, hypercalcemia, dermatomyositis, and polycythemia. Many patients had a history of prostate adenocarcinoma treated with androgen deprivation therapy (ADT) before neuroendocrine features developed. The mean age was 65.5 years, with a maximum survival of 9 months post-diagnosis. NEPC is becoming an increasingly more common subtype of PCa that can result in various PNS. This makes the diagnosis and treatment of NEPC challenging. Further research is crucial to understanding these syndromes and developing standardized, targeted treatments to improve patient survival.

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The temporal relationship of paraneoplastic aquaporin-4-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD) and breast cancer: a systematic review and meta-analysis

et al. 2023

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AQP4-IgG-positive neuromyelitis optica spectrum disorder and temporally detected neoplasms: case report and systematic review

Cited by 6 publications

References 75 publications

A 51-Year-Old Woman with Advanced Breast Cancer and a 2-Week History of Nausea and Vomiting Due to Neuromyelitis Optica Spectrum Disorder (NMOSD) and Seropositivity to Aquaporin-4 (AQP-4)

A 51-Year-Old Woman with Advanced Breast Cancer and a 2-Week History of Nausea and Vomiting Due to Neuromyelitis Optica Spectrum Disorder (NMOSD) and Seropositivity to Aquaporin-4 (AQP-4)

Paraneoplastic Syndromes in Neuroendocrine Prostate Cancer: A Systematic Review

The temporal relationship of paraneoplastic aquaporin-4-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD) and breast cancer: a systematic review and meta-analysis

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