Antibodies to CV2/CRMP5 in neuromyelitis optica-like disease: Case report and review of the literature

Abstract Neuromyelitis optica (NMO) is associated with antibodies to aquaporin-4 (termed NMO-IgG or AQP4-Ab) in 60–90% of cases. Little is known about the aetiology of NMO in NMO-IgG/AQP4-Ab negative patients. Here we report on CV2/CRMP5 antibodies in a 69-year-old male patient with NMO-IgG/AQP4-Ab...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2012-05, Vol.114 (4), p.331-335
Main Authors: Jarius, S, Wandinger, K.P, Borowski, K, Stoecker, W, Wildemann, B
Format: Article
Language:English
Subjects:
Abdomen - diagnostic imaging
Aged
Antibodies
Aquaporin 4
Aquaporin 4 - immunology
Aquaporin-4 antibody
Autoantibodies - analysis
Biological and medical sciences
Brain
Cancer therapies
Case reports
Colonoscopy
CRMP5 antibody
CV2 antibody
Diagnosis, Differential
Differential diagnosis
Disease
Disease Progression
Evoked Potentials, Visual - physiology
Gastroscopy
Humans
Immunofluorescence
Immunopathogenesis
Legs
Literature reviews
Longitudinally extensive transverse myelitis
Magnetic Resonance Imaging
Male
Medical sciences
Muscle Weakness - etiology
Nerve Tissue Proteins - immunology
Neurology
Neuromyelitis
Neuromyelitis optica (Devic syndrome)
Neuromyelitis Optica - cerebrospinal fluid
Neuromyelitis Optica - immunology
Neurosurgery
NMO-IgG
Optic neuritis
Paraneoplastic neurological disorders
Paraneoplastic Syndromes - pathology
Paraparesis - etiology
Plasma
Positron-Emission Tomography
Prostate cancer
Prostatic Neoplasms - complications
Spinal cord
Spine - diagnostic imaging
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tomography, X-Ray Computed
Tumors
Ultrasonography
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Description
Summary:Abstract Neuromyelitis optica (NMO) is associated with antibodies to aquaporin-4 (termed NMO-IgG or AQP4-Ab) in 60–90% of cases. Little is known about the aetiology of NMO in NMO-IgG/AQP4-Ab negative patients. Here we report on CV2/CRMP5 antibodies in a 69-year-old male patient with NMO-IgG/AQP4-Ab negative NMO. The association of CV2/CRMP5-Ab with prostate cancer suggests a paraneoplastic aetiology of NMO in our patient. Our report strengthens the case of antibodies other than AQP4-Ab being involved in the immunopathogenesis in a subset of patients with NMO. We conclude that CV2/CRMP5-Ab should be included in the differential diagnosis of NMO, in particular if AQP4-Ab are negative and irrespective of whether a tumour is known or not. We recommend that recombinant tests, which are increasingly used because of their higher sensitivity and specificity, should always be accompanied by standard indirect immunofluorescence employing brain tissue sections in order to avoid CV2/CRMP5-Ab or other paraneoplastic antibodies being overlooked. In addition, we provide a comprehensive review of all patients with CV2/CRMP5-Ab and NMO-like disease published in the English literature so far.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2011.10.048