Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

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Resumé

Background: Serum autoantibody against the astrocytic water channel aquaporin 4 (AQP4-IgG) is a biomarker for neuromyelitis optica spectrum disorder (NMOSD). In some patients the presence of AQP4-IgG reflects a tumor-driven immune response.

Methods: AQP4-IgG was measured with a recombinant immunofluorescence assay1. Clinical data and MRI were reviewed.

Case: A 64-year old man developed sudden loss of vision and reduced visual field in both eyes. Visual acuity was 1/36 and 6/24 in the right and left eye, respectively. The optic disc was swollen, mostly in the right eye and bilateral optic neuritis (ON) was diagnosed by an ophthalmologist. Brain MRI and cerebrospinal fluid (CSF) intracranial pressure were normal. CSF showed 4 leukocytes, oligoclonal bands and normal IgG index and protein level. At follow-up after three month atrophy and visual loss (2/36) of the right eye was apparent.
Two years earlier than ON the patient had been treated for thyroid cancer, by thyroidectomy and radioactive iodine. Five years later he was diagnosed with disseminated colon cancer. Further three years later he was still positive for AQP4-IgG, had no relapse of NMOSD and died due to his cancer.

Conclusions: This case suggests that AQP4 autoimmunity may in some cases have a paraneoplastic basis.



1. Asgari N, Nielsen C, Stenager E, Kyvik KO, Lillevang ST. HLA, PTPN22 and PD-1 associations as markers of autoimmunity in neuromyelitis optica. Multiple Sclerosis. 2012;18(1):23-30.


OriginalsprogEngelsk
Publikationsdatomar. 2015
Antal sider1
StatusUdgivet - mar. 2015
BegivenhedDansk Neurologisk Selskabs Årsmøde - Hotel Munkebjerg, Vejle, Danmark
Varighed: 13. mar. 201514. mar. 2015

Konference

KonferenceDansk Neurologisk Selskabs Årsmøde
LokationHotel Munkebjerg
LandDanmark
ByVejle
Periode13/03/201514/03/2015

Citer dette

Soelberg, K., Grauslund, J., Lillevang, S. T., & Asgari, N. (2015). Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context. Poster session præsenteret på Dansk Neurologisk Selskabs Årsmøde, Vejle, Danmark.
Soelberg, Kerstin ; Grauslund, Jakob ; Lillevang, Søren Thue ; Asgari, Nasrin. / Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context. Poster session præsenteret på Dansk Neurologisk Selskabs Årsmøde, Vejle, Danmark.1 s.
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title = "Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context",
abstract = "Background: Serum autoantibody against the astrocytic water channel aquaporin 4 (AQP4-IgG) is a biomarker for neuromyelitis optica spectrum disorder (NMOSD). In some patients the presence of AQP4-IgG reflects a tumor-driven immune response. Methods: AQP4-IgG was measured with a recombinant immunofluorescence assay1. Clinical data and MRI were reviewed. Case: A 64-year old man developed sudden loss of vision and reduced visual field in both eyes. Visual acuity was 1/36 and 6/24 in the right and left eye, respectively. The optic disc was swollen, mostly in the right eye and bilateral optic neuritis (ON) was diagnosed by an ophthalmologist. Brain MRI and cerebrospinal fluid (CSF) intracranial pressure were normal. CSF showed 4 leukocytes, oligoclonal bands and normal IgG index and protein level. At follow-up after three month atrophy and visual loss (2/36) of the right eye was apparent.Two years earlier than ON the patient had been treated for thyroid cancer, by thyroidectomy and radioactive iodine. Five years later he was diagnosed with disseminated colon cancer. Further three years later he was still positive for AQP4-IgG, had no relapse of NMOSD and died due to his cancer.Conclusions: This case suggests that AQP4 autoimmunity may in some cases have a paraneoplastic basis.1. Asgari N, Nielsen C, Stenager E, Kyvik KO, Lillevang ST. HLA, PTPN22 and PD-1 associations as markers of autoimmunity in neuromyelitis optica. Multiple Sclerosis. 2012;18(1):23-30.",
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Soelberg, K, Grauslund, J, Lillevang, ST & Asgari, N 2015, 'Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context' Dansk Neurologisk Selskabs Årsmøde, Vejle, Danmark, 13/03/2015 - 14/03/2015, .

Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context. / Soelberg, Kerstin; Grauslund, Jakob; Lillevang, Søren Thue; Asgari, Nasrin.

2015. Poster session præsenteret på Dansk Neurologisk Selskabs Årsmøde, Vejle, Danmark.

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

TY - CONF

T1 - Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context

AU - Soelberg, Kerstin

AU - Grauslund, Jakob

AU - Lillevang, Søren Thue

AU - Asgari, Nasrin

PY - 2015/3

Y1 - 2015/3

N2 - Background: Serum autoantibody against the astrocytic water channel aquaporin 4 (AQP4-IgG) is a biomarker for neuromyelitis optica spectrum disorder (NMOSD). In some patients the presence of AQP4-IgG reflects a tumor-driven immune response. Methods: AQP4-IgG was measured with a recombinant immunofluorescence assay1. Clinical data and MRI were reviewed. Case: A 64-year old man developed sudden loss of vision and reduced visual field in both eyes. Visual acuity was 1/36 and 6/24 in the right and left eye, respectively. The optic disc was swollen, mostly in the right eye and bilateral optic neuritis (ON) was diagnosed by an ophthalmologist. Brain MRI and cerebrospinal fluid (CSF) intracranial pressure were normal. CSF showed 4 leukocytes, oligoclonal bands and normal IgG index and protein level. At follow-up after three month atrophy and visual loss (2/36) of the right eye was apparent.Two years earlier than ON the patient had been treated for thyroid cancer, by thyroidectomy and radioactive iodine. Five years later he was diagnosed with disseminated colon cancer. Further three years later he was still positive for AQP4-IgG, had no relapse of NMOSD and died due to his cancer.Conclusions: This case suggests that AQP4 autoimmunity may in some cases have a paraneoplastic basis.1. Asgari N, Nielsen C, Stenager E, Kyvik KO, Lillevang ST. HLA, PTPN22 and PD-1 associations as markers of autoimmunity in neuromyelitis optica. Multiple Sclerosis. 2012;18(1):23-30.

AB - Background: Serum autoantibody against the astrocytic water channel aquaporin 4 (AQP4-IgG) is a biomarker for neuromyelitis optica spectrum disorder (NMOSD). In some patients the presence of AQP4-IgG reflects a tumor-driven immune response. Methods: AQP4-IgG was measured with a recombinant immunofluorescence assay1. Clinical data and MRI were reviewed. Case: A 64-year old man developed sudden loss of vision and reduced visual field in both eyes. Visual acuity was 1/36 and 6/24 in the right and left eye, respectively. The optic disc was swollen, mostly in the right eye and bilateral optic neuritis (ON) was diagnosed by an ophthalmologist. Brain MRI and cerebrospinal fluid (CSF) intracranial pressure were normal. CSF showed 4 leukocytes, oligoclonal bands and normal IgG index and protein level. At follow-up after three month atrophy and visual loss (2/36) of the right eye was apparent.Two years earlier than ON the patient had been treated for thyroid cancer, by thyroidectomy and radioactive iodine. Five years later he was diagnosed with disseminated colon cancer. Further three years later he was still positive for AQP4-IgG, had no relapse of NMOSD and died due to his cancer.Conclusions: This case suggests that AQP4 autoimmunity may in some cases have a paraneoplastic basis.1. Asgari N, Nielsen C, Stenager E, Kyvik KO, Lillevang ST. HLA, PTPN22 and PD-1 associations as markers of autoimmunity in neuromyelitis optica. Multiple Sclerosis. 2012;18(1):23-30.

M3 - Poster

ER -

Soelberg K, Grauslund J, Lillevang ST, Asgari N. Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context. 2015. Poster session præsenteret på Dansk Neurologisk Selskabs Årsmøde, Vejle, Danmark.