Association of anti-aquaporin-4 antibody-positive neuromyelitis optica with myasthenia gravis.
We describe 2 patients who developed anti-aquaporin-4 antibody-positive neuromyelitis optica (NMO) following the development of anti-acetylcholine receptor antibody-positive myasthenia gravis (MG). A literature review of 13 similar cases in addition to the present 2 cases of NMO with MG showed predominance among Asian women and frequent development of NMO following thymectomy for MG. Moreover, in one of our patients, serial assays of anti-aquaporin-4 antibody and anti-acetylcholine receptor antibody were performed. Accumulating evidence for the coexistence of NMO and MG suggests that a common immunopathogenesis of NMO and MG may exist, and the association of NMO with MG may be more frequent than hitherto believed.
Uzawa
Akiyuki
A
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. a-uzimp1204@graduate.chiba-u.jp
Mori
Masahiro
M
Iwai
Yuhta
Y
Kobayashi
Makoto
M
Hayakawa
Sei
S
Kawaguchi
Naoki
N
Kuwabara
Satoshi
S
D051401:Aquaporin 4 / Q000032:analysis / Q000378:metabolism*; D044466:Asian People; D001323:Autoantibodies / Q000032:analysis / Q000378:metabolism; D015551:Autoimmunity / Q000276:immunology; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001766:Blindness / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D002490:Central Nervous System / Q000276:immunology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications* / Q000276:immunology* / Q000503:physiopathology; D009469:Neuromuscular Junction / Q000276:immunology / Q000503:physiopathology; D009471:Neuromyelitis Optica / Q000276:immunology* / Q000378:metabolism* / Q000503:physiopathology; D009900:Optic Nerve / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D017933:Peripheral Nervous System / Q000276:immunology / Q000503:physiopathology; D011782:Quadriplegia / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D044469:Racial Groups; D011950:Receptors, Cholinergic / Q000276:immunology; D013116:Spinal Cord / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D013934:Thymectomy / Q000009:adverse effects
C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers; D011950:Receptors, Cholinergic