Longitudinally extensive transverse myelitis with AQP4 antibodies revealing ovarian teratoma

J Neuroimmunol. 2013 Oct 15;263(1-2):145-7. doi: 10.1016/j.jneuroim.2013.07.003. Epub 2013 Jul 27.

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.

Keywords: Autoimmune diseases; Paraneoplastic syndrome; Transverse myelitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aquaporin 4 / blood
  • Aquaporin 4 / cerebrospinal fluid
  • Aquaporin 4 / immunology*
  • Autoantibodies / biosynthesis*
  • Autoantibodies / blood
  • Autoantibodies / cerebrospinal fluid
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Diagnosis, Differential
  • Female
  • Humans
  • Myelitis, Transverse / diagnosis
  • Myelitis, Transverse / immunology*
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / immunology*
  • Teratoma / diagnosis
  • Teratoma / immunology*

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Autoantibodies
  • Biomarkers