| Extensive hemispheric lesions with radiological evidence of blood-brain barrier integrity in a patient with neuromyelitis optica. | |
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MedLine Citation:
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PMID: 19497587 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Anti-aquaporin-4 antibody (NMO-IgG) is used as a diagnostic marker for neuromyelitis optica (NMO). Although the mechanism of spinal cord lesions in NMO has been investigated, that of extensive hemispheric lesions with brain edema remains unclear. Here we report a 36-year-old woman with NMO positive for NMO-IgG, who developed an acute disseminating encephalomyelitis (ADEM)-like episode after Mycoplasma pneumoniae infection. Brain MRI T2-weighted images demonstrated asymmetric tumefactive hyperintense lesions in the subcortical white matter. Importantly, no lesions on T1-weighted images were enhanced after intravenous gadolinium administration on serial brain MRIs, suggesting preserved integrity of the blood-brain barrier (BBB). Likewise, the corresponding apparent diffusion coefficient maps demonstrated persistent hyperintensity changes, which represented vasogenic edema associated with glial damage and consequent neuronal loss. The findings suggest possible involvement of deficient water elimination associated with seropositivity to NMO-IgG in the induction of vasogenic edema even in the presence of intact and functional BBB. |
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Authors:
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Shinji Saiki; Yuji Ueno; Toshio Moritani; Takeshi Sato; Takeshi Sekine; Sumihiro Kawajiri; Satoshi Adachi; Kazumasa Yokoyama; Yuji Tomizawa; Yumiko Motoi; Nobutaka Hattori |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-06-03 |
Journal Detail:
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Title: Journal of the neurological sciences Volume: 284 ISSN: 1878-5883 ISO Abbreviation: J. Neurol. Sci. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-05 Completed Date: 2009-12-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375403 Medline TA: J Neurol Sci Country: Netherlands |
Other Details:
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Languages: eng Pagination: 217-9 Citation Subset: IM |
Affiliation:
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Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. ssaiki@juntendo.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aquaporin 4 / immunology* Autoantibodies / immunology* Autoantigens / immunology* Blood-Brain Barrier Brain Edema / etiology, physiopathology Contrast Media / pharmacokinetics Diagnostic Errors Diffusion Magnetic Resonance Imaging* Encephalomyelitis, Acute Disseminated / etiology*, physiopathology Female Gadolinium / diagnostic use, pharmacokinetics Humans Interferon-beta / adverse effects, therapeutic use Magnetic Resonance Imaging Multiple Sclerosis / diagnosis, drug therapy Mycoplasma pneumoniae Myelitis, Transverse / etiology Neuromyelitis Optica / diagnosis*, immunology, pathology, radiography Pneumonia, Mycoplasma / complications* |
| Chemical | |
Reg. No./Substance:
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0/AQP4 protein, human; 0/Aquaporin 4; 0/Autoantibodies; 0/Autoantigens; 0/Contrast Media; 145155-23-3/interferon beta-1b; 7440-54-2/Gadolinium; 77238-31-4/Interferon-beta |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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