Elderly-Onset Neuromyelitis Optica which Developed after the Diagnosis of Prostate Adenocarcinoma and Relapsed after a 23-Valent Pneumococcal Polysaccharide Vaccination
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概要
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We report a case of elderly-onset neuromyelitis optica (NMO) positive for the anti-aquaporin-4 (AQP-4) antibody; symptoms developed after the diagnosis of prostate adenocarcinoma and relapsed after a 23-valent pneumococcal polysaccharide vaccination. We suggest that activation of CD4-positive T cells and secretion of interferon-gamma induced by adenocarcinoma and complement activation induced by vaccination are responsible for the onset and relapse of NMO, even if a patient is positive for the anti-AQP-4 antibody. This case supports the previous experimental finding that the anti-AQP-4 antibody does not cause NMO-like lesions when injected alone, but does so after the induction of T cell-mediated experimental autoimmune encephalomyelitis or when co-injected with human complement.
著者
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Bandoh Mitsuaki
Department Of Neurology Tokyo Metropolitan Neurological Hospital
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Matsubara Shiro
Department Of Neurology Tokyo Metropolitan Neurological Hospital
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Takahashi Toshiyuki
Department of Applied Chemistry, Faculty of Science and Engineering, Kinki University
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Bandoh Mitsuaki
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan
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Kitazawa Yu
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan
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Warabi Yoko
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan
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