MOG antibody-positive paraneoplastic myelopathy in breast carcinoma: the new culprit

Cherian, Ajith; Shetty, Sharath Chandra; Kajaria, Divya; Prabhakaran, Pranab K; Pavuluri, Harini; Paramasivan, Naveen Kumar

doi:10.1007/s13760-021-01602-8

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…MOG antibodies are only rarely found in people with multiple sclerosis or AQP4 antibody‐positive NMOSD 14 . Paraneoplastic MOG encephalomyelitis has been associated with a variety of cancers, including lymphoma, multiple myeloma, and lung, breast and ovarian cancer 15–17 . A patient with an ovarian tumor with paraneoplastic rapidly progressive encephalomyeloradiculitis was positive for anti‐inositol 1,4,5‐trisphosphate receptor type 1, anti‐glial fibrillary acidic protein and anti‐MOG antibodies 15 …”

Section: Discussionmentioning

confidence: 99%

“…14 Paraneoplastic MOG encephalomyelitis has been associated with a variety of cancers, including lymphoma, multiple myeloma, and lung, breast and ovarian cancer. [15][16][17] A patient with an ovarian tumor with paraneoplastic rapidly progressive encephalomyeloradiculitis was positive for anti-inositol 1,4,5-trisphosphate receptor type 1, anti-glial fibrillary acidic protein and anti-MOG antibodies. 15 Patients with MOGAD and NMOSD typically present with recurrent neurological episodes, including optic neuritis and acute myelitis.…”

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confidence: 99%

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Anti‐aquaporin‐4 immunoglobulin G/anti‐myelin oligodendrocyte glycoprotein immunoglobulin G double‐positive paraneoplastic neurological syndrome in a patient with triple‐negative breast cancer

Siddiqui,

Ross,

Jani

et al. 2023

Clinical & Exp Neuroim

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We report a rare case of paraneoplastic neurological syndrome with dual seropositivity of anti‐aquaporin‐4 and myelin oligodendrocyte glycoprotein antibodies in a 40 year‐old woman with metastatic triple‐negative breast cancer. She received multiple lines of anti‐neoplastic treatment, including immunotherapy with pembrolizumab, as well as cytotoxic chemotherapy. Paraneoplastic meningoencephalomyelitis developed 2 years after diagnosis of breast cancer and 1 year after discontinuation of immunotherapy with pembrolizumab. She first developed longitudinally extending transverse myelitis followed by left optic neuritis and meningoencephalitis with new enhancing lesions in the brain and spinal leptomeninges. Cerebrospinal fluid analysis during both episodes showed normal glucose and protein, and elevated white blood cell count. Cytology was negative for malignancy. Cerebrospinal fluid was positive for neuromyelitis optica immunoglobulin G antibody anti‐aquaporin‐4, and autoimmune myelopathy panel was positive for myelin oligodendrocyte glycoprotein antibody. The patient had significant clinical and radiographic improvement after completion of five cycles of plasmapheresis followed by intravenous immunoglobulin. She did not have recurrence of paraneoplastic syndrome with maintenance rituximab every 6 months and daily low‐dose prednisone. She succumbed to progressive systemic metastatic disease 4.5 years after her breast cancer diagnosis. This case shows that these antibodies can occur concurrently and cause clinical features, such as both neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody disease, in a patient with a singular type of cancer. We highlight the importance of testing for paraneoplastic etiology in cancer patients with radiographic menigoencephalomyelitis or meningitis with atypical symptoms of meningeal carcinomatosis and/or cerebrospinal fluid profile negative for leptomeningeal carcinomatosis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Anti‐aquaporin‐4 immunoglobulin G/anti‐myelin oligodendrocyte glycoprotein immunoglobulin G double‐positive paraneoplastic neurological syndrome in a patient with triple‐negative breast cancer

Siddiqui,

Ross,

Jani

et al. 2023

Clinical & Exp Neuroim

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“…MOGAD was perceived primarily as a monophasic CNS inflammatory disease, but further observations showed that a relapsing course occur in 28–60% of patients, and in up to 83% of cases with long-term observation, especially those with persistent positive MOG-IgG status. 99,143 Some evidence of subclinical disease activity and progression has been shown to be present in some of the patients with MOGAD. 2 Patients with anti-NMDAR-EN tend to have more severe neurologic presentations, and poor long-term functional outcomes, and the mortality rate has been reported between 5% and 7%.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune diseases and cancers overlapping with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): A systematic review

Molazadeh

Bose

Lotan

et al. 2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has various similarities with AQP4-IgG-seropositive Neuromyelitis Optica Spectrum Disorder (AQP4-IgG + NMOSD) in terms of clinical presentations, magnetic resonance imaging (MRI) findings, and response to treatment. But unlike AQP4-IgG + NMOSD, which is known to coexist with various autoimmune diseases and cancers, an association of MOGAD with these conditions is less clear. Methods We conducted a systematic search in PubMed, Scopus, Web of Science, and Embase based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Duplicates were removed using Mendeley 1.19.8 (USA production) and the citations were uploaded into Covidence systematic review platform for screening. Results The most common autoimmune disease overlapping with MOGAD was anti-N-Methyl-D-Aspartate receptor encephalitis (anti-NMDAR-EN), followed by autoimmune thyroid disorders, and the most common autoantibody was antinuclear antibody (ANA), followed by AQP4-IgG (double-positive MOG-IgG and AQP4-IgG). A few sporadic cases of cancers and MOG-IgG-associated paraneoplastic encephalomyelitis were found. Conclusion Unlike AQP4-IgG + NMOSD, MOGAD lacks clustering of autoimmune diseases and autoantibodies associated with systemic and organ-specific autoimmunity. Other than anti-NMDAR-EN and perhaps AQP4-IgG + NMOSD, the evidence thus far does not support the need for routine screening of overlapping autoimmunity and neoplasms in patients with MOGAD.

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Antibodies to neural cell surface and synaptic proteins in paraneoplastic neurologic syndromes

Budhram,

Sechi

2024

Handbook of Clinical Neurology

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MOG antibody-positive paraneoplastic myelopathy in breast carcinoma: the new culprit

Cited by 6 publications

References 5 publications

Anti‐aquaporin‐4 immunoglobulin G/anti‐myelin oligodendrocyte glycoprotein immunoglobulin G double‐positive paraneoplastic neurological syndrome in a patient with triple‐negative breast cancer

Anti‐aquaporin‐4 immunoglobulin G/anti‐myelin oligodendrocyte glycoprotein immunoglobulin G double‐positive paraneoplastic neurological syndrome in a patient with triple‐negative breast cancer

Autoimmune diseases and cancers overlapping with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): A systematic review

Antibodies to neural cell surface and synaptic proteins in paraneoplastic neurologic syndromes

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