title: Longitudinally extensive transverse myelitis with AQP4 antibodies revealing ovarian teratoma.
abstract: Paraneoplastic myelitis is a rare inflammatory disorder most frequently associated with solid tumors or lymphoproliferative disorders. Patients often harbor onconeuronal antibodies and their prognosis is usually poor. Here we report a 42-year old woman with longitudinally extensive transverse myelitis and aquaporin-4 (AQP4) antibodies that led to the diagnosis of ovarian teratoma. After tumor removal and immune therapy (including corticosteroids, plasma exchange, intravenous immunoglobulins and rituximab) the patient progressively improved achieving complete recovery. Histological study of the teratoma demonstrated neural tissue containing AQP4 expressing cells and intense inflammatory infiltrates, providing evidence for a possible paraneoplastic link between both disorders.
authors.affiliation: Department of Neurology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Frasquet
authors.forename: Luis
authors.initials: L
authors.lastname: Bataller
authors.forename: Estefanía
authors.initials: E
authors.lastname: Torres-Vega
authors.forename: María
authors.initials: M
authors.lastname: Durán-Moreno
authors.forename: José M
authors.initials: JM
authors.lastname: García-Verdugo
authors.forename: Teresa
authors.initials: T
authors.lastname: Sevilla
authors.forename: Salvador
authors.initials: S
authors.lastname: Rivas
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Miralles
authors.forename: María
authors.initials: M
authors.lastname: Simó-Castelló
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Casanova
mesh_terms: D000328:Adult; D051401:Aquaporin 4 / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology*; D001323:Autoantibodies / Q000096:biosynthesis* / Q000097:blood / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009188:Myelitis, Transverse / Q000175:diagnosis / Q000276:immunology*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000276:immunology*; D013724:Teratoma / Q000175:diagnosis / Q000276:immunology*
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers
keywords: Autoimmune diseases; Paraneoplastic syndrome; Transverse myelitis