Abstract
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.
MeSH terms
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Aquaporin 4 / analysis
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Aquaporin 4 / metabolism*
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Asian People
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Autoantibodies / analysis
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Autoantibodies / metabolism
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Autoimmunity / immunology
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Biomarkers / analysis
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Biomarkers / metabolism
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Blindness / immunology
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Blindness / pathology
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Blindness / physiopathology
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Central Nervous System / immunology
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Central Nervous System / physiopathology
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Disease Progression
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Female
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Humans
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Middle Aged
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Myasthenia Gravis / complications*
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Myasthenia Gravis / immunology*
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Myasthenia Gravis / physiopathology
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Neuromuscular Junction / immunology
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Neuromuscular Junction / physiopathology
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Neuromyelitis Optica / immunology*
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Neuromyelitis Optica / metabolism*
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Neuromyelitis Optica / physiopathology
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Optic Nerve / immunology
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Optic Nerve / pathology
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Optic Nerve / physiopathology
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Peripheral Nervous System / immunology
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Peripheral Nervous System / physiopathology
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Quadriplegia / immunology
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Quadriplegia / pathology
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Quadriplegia / physiopathology
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Racial Groups
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Receptors, Cholinergic / immunology
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Spinal Cord / immunology
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Spinal Cord / pathology
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Spinal Cord / physiopathology
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Thymectomy / adverse effects
Substances
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AQP4 protein, human
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Aquaporin 4
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Autoantibodies
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Biomarkers
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Receptors, Cholinergic