title: Paraneoplastic neuromyelitis optica spectrum disorder associated with metastatic carcinoid expressing aquaporin-4.
abstract: OBJECTIVE
  Reports of neuromyelitis optica spectrum disorder (NMOSD) occurring in the setting of neoplasia suggest that aquaporin-4 autoimmunity may in some cases have a paraneoplastic basis.
  
  
  METHODS
  In this case report, we describe a patient with NMOSD whose test results were seropositive for aquaporin-4 IgG and who had a hepatic metastasis from a small-bowel neuroendocrine tumor. The tumor cells expressed aquaporin-4 immunoreactivity. She presented to the Neurology Department at Wayne State University with bilateral leg weakness, ascending paresthesias, and decreased sensation.
  
  
  CONCLUSIONS
  This case extends the context of NMOSD as a paraneoplastic disorder.
authors.affiliation: Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Michelle
authors.initials: M
authors.lastname: Figueroa
authors.affiliation: Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Yong
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Tselis
authors.affiliation: Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Pittock
authors.affiliation: Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota3Department of Laboratory Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota4Department of Pathology and Immunology, Mayo Clinic College of Medicine, Rochester, Min.
authors.forename: Vanda A
authors.initials: VA
authors.lastname: Lennon
authors.affiliation: Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Claudia F
authors.initials: CF
authors.lastname: Lucchinetti
authors.affiliation: Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan5Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Lisak
mesh_terms: D051401:Aquaporin 4 / Q000096:biosynthesis / Q000235:genetics*; D002276:Carcinoid Tumor / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D005260:Female; D005786:Gene Expression Regulation / Q000276:immunology; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000556:secondary; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology; D020361:Paraneoplastic Syndromes, Nervous System / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4
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