Autoimmune myelopathies

Research output: Chapter in Book/Report/Conference proceedingConference contribution

14 Citations (Scopus)

Abstract

Autoimmune myelopathies are a heterogeneous group of immune-mediated spinal cord disorders with a broad differential diagnosis. They encompass myelopathies with an immune attack on the spinal cord (e.g., aquaporin-4-IgG (AQP4-IgG) seropositive neuromyelitis optica (NMO) and its spectrum disorders (NMOSD)), myelopathies occurring with systemic autoimmune disorders (which may also be due to coexisting NMO/NMOSD), paraneoplastic autoimmune myelopathies, postinfectious autoimmune myelopathies (e.g., acute disseminated encephalomyelitis), and myelopathies thought to be immune-related (e.g., multiple sclerosis and spinal cord sarcoidosis). Spine magnetic resonance imaging is extremely useful in the evaluation of autoimmune myelopathies as the location of signal change, length of the lesion, gadolinium enhancement pattern, and evolution over time narrow the differential diagnosis considerably. The recent discovery of multiple novel neural-specific autoantibodies accompanying autoimmune myelopathies has improved their classification. These autoantibodies may be pathogenic (e.g., AQP4-IgG) or nonpathogenic and more reflective of a cytotoxic T-cell-mediated autoimmune response (collapsin response mediator protein-5(CRMP5)-IgG). The presence of an autoantibody may help guide cancer search, assist treatment decisions, and predict outcome/relapse. With paraneoplastic myelopathies the initial goal is detection and treatment of the underlying cancer. The aim of immunotherapy in all autoimmune myelopathies is to maximize reversibility, maintain benefits (while preventing relapse), and minimize side effects.

Original languageEnglish (US)
Title of host publicationAutoimmune Neurology, 2016
EditorsSean J. Pittock, Angela Vincent
PublisherElsevier B.V.
Pages327-351
Number of pages25
ISBN (Print)9780444634320
DOIs
StatePublished - Jan 1 2016

Publication series

NameHandbook of Clinical Neurology
Volume133
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Fingerprint

Spinal Cord Diseases
Neuromyelitis Optica
Autoantibodies
Aquaporin 4
Immunoglobulin G
Spinal Cord
Differential Diagnosis
Semaphorin-3A
Acute Disseminated Encephalomyelitis
Recurrence
Gadolinium
Sarcoidosis
Autoimmunity
Immunotherapy
Multiple Sclerosis
Neoplasms
Spine
Magnetic Resonance Imaging
T-Lymphocytes

Keywords

  • Aquaporin-4-IgG
  • Autoimmune myelopathy
  • Neuromyelitis optica
  • Paraneoplastic myelopathy
  • Spinal cord sarcoidosis
  • Transverse myelitis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Flanagan, E. (2016). Autoimmune myelopathies. In S. J. Pittock, & A. Vincent (Eds.), Autoimmune Neurology, 2016 (pp. 327-351). (Handbook of Clinical Neurology; Vol. 133). Elsevier B.V.. https://doi.org/10.1016/B978-0-444-63432-0.00019-0

Autoimmune myelopathies. / Flanagan, Eoin.

Autoimmune Neurology, 2016. ed. / Sean J. Pittock; Angela Vincent. Elsevier B.V., 2016. p. 327-351 (Handbook of Clinical Neurology; Vol. 133).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Flanagan, E 2016, Autoimmune myelopathies. in SJ Pittock & A Vincent (eds), Autoimmune Neurology, 2016. Handbook of Clinical Neurology, vol. 133, Elsevier B.V., pp. 327-351. https://doi.org/10.1016/B978-0-444-63432-0.00019-0
Flanagan E. Autoimmune myelopathies. In Pittock SJ, Vincent A, editors, Autoimmune Neurology, 2016. Elsevier B.V. 2016. p. 327-351. (Handbook of Clinical Neurology). https://doi.org/10.1016/B978-0-444-63432-0.00019-0
Flanagan, Eoin. / Autoimmune myelopathies. Autoimmune Neurology, 2016. editor / Sean J. Pittock ; Angela Vincent. Elsevier B.V., 2016. pp. 327-351 (Handbook of Clinical Neurology).
@inproceedings{c5dde2417f8a4307852a602bc7448222,
title = "Autoimmune myelopathies",
abstract = "Autoimmune myelopathies are a heterogeneous group of immune-mediated spinal cord disorders with a broad differential diagnosis. They encompass myelopathies with an immune attack on the spinal cord (e.g., aquaporin-4-IgG (AQP4-IgG) seropositive neuromyelitis optica (NMO) and its spectrum disorders (NMOSD)), myelopathies occurring with systemic autoimmune disorders (which may also be due to coexisting NMO/NMOSD), paraneoplastic autoimmune myelopathies, postinfectious autoimmune myelopathies (e.g., acute disseminated encephalomyelitis), and myelopathies thought to be immune-related (e.g., multiple sclerosis and spinal cord sarcoidosis). Spine magnetic resonance imaging is extremely useful in the evaluation of autoimmune myelopathies as the location of signal change, length of the lesion, gadolinium enhancement pattern, and evolution over time narrow the differential diagnosis considerably. The recent discovery of multiple novel neural-specific autoantibodies accompanying autoimmune myelopathies has improved their classification. These autoantibodies may be pathogenic (e.g., AQP4-IgG) or nonpathogenic and more reflective of a cytotoxic T-cell-mediated autoimmune response (collapsin response mediator protein-5(CRMP5)-IgG). The presence of an autoantibody may help guide cancer search, assist treatment decisions, and predict outcome/relapse. With paraneoplastic myelopathies the initial goal is detection and treatment of the underlying cancer. The aim of immunotherapy in all autoimmune myelopathies is to maximize reversibility, maintain benefits (while preventing relapse), and minimize side effects.",
keywords = "Aquaporin-4-IgG, Autoimmune myelopathy, Neuromyelitis optica, Paraneoplastic myelopathy, Spinal cord sarcoidosis, Transverse myelitis",
author = "Eoin Flanagan",
year = "2016",
month = "1",
day = "1",
doi = "10.1016/B978-0-444-63432-0.00019-0",
language = "English (US)",
isbn = "9780444634320",
series = "Handbook of Clinical Neurology",
publisher = "Elsevier B.V.",
pages = "327--351",
editor = "Pittock, {Sean J.} and Angela Vincent",
booktitle = "Autoimmune Neurology, 2016",

}

TY - GEN

T1 - Autoimmune myelopathies

AU - Flanagan, Eoin

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Autoimmune myelopathies are a heterogeneous group of immune-mediated spinal cord disorders with a broad differential diagnosis. They encompass myelopathies with an immune attack on the spinal cord (e.g., aquaporin-4-IgG (AQP4-IgG) seropositive neuromyelitis optica (NMO) and its spectrum disorders (NMOSD)), myelopathies occurring with systemic autoimmune disorders (which may also be due to coexisting NMO/NMOSD), paraneoplastic autoimmune myelopathies, postinfectious autoimmune myelopathies (e.g., acute disseminated encephalomyelitis), and myelopathies thought to be immune-related (e.g., multiple sclerosis and spinal cord sarcoidosis). Spine magnetic resonance imaging is extremely useful in the evaluation of autoimmune myelopathies as the location of signal change, length of the lesion, gadolinium enhancement pattern, and evolution over time narrow the differential diagnosis considerably. The recent discovery of multiple novel neural-specific autoantibodies accompanying autoimmune myelopathies has improved their classification. These autoantibodies may be pathogenic (e.g., AQP4-IgG) or nonpathogenic and more reflective of a cytotoxic T-cell-mediated autoimmune response (collapsin response mediator protein-5(CRMP5)-IgG). The presence of an autoantibody may help guide cancer search, assist treatment decisions, and predict outcome/relapse. With paraneoplastic myelopathies the initial goal is detection and treatment of the underlying cancer. The aim of immunotherapy in all autoimmune myelopathies is to maximize reversibility, maintain benefits (while preventing relapse), and minimize side effects.

AB - Autoimmune myelopathies are a heterogeneous group of immune-mediated spinal cord disorders with a broad differential diagnosis. They encompass myelopathies with an immune attack on the spinal cord (e.g., aquaporin-4-IgG (AQP4-IgG) seropositive neuromyelitis optica (NMO) and its spectrum disorders (NMOSD)), myelopathies occurring with systemic autoimmune disorders (which may also be due to coexisting NMO/NMOSD), paraneoplastic autoimmune myelopathies, postinfectious autoimmune myelopathies (e.g., acute disseminated encephalomyelitis), and myelopathies thought to be immune-related (e.g., multiple sclerosis and spinal cord sarcoidosis). Spine magnetic resonance imaging is extremely useful in the evaluation of autoimmune myelopathies as the location of signal change, length of the lesion, gadolinium enhancement pattern, and evolution over time narrow the differential diagnosis considerably. The recent discovery of multiple novel neural-specific autoantibodies accompanying autoimmune myelopathies has improved their classification. These autoantibodies may be pathogenic (e.g., AQP4-IgG) or nonpathogenic and more reflective of a cytotoxic T-cell-mediated autoimmune response (collapsin response mediator protein-5(CRMP5)-IgG). The presence of an autoantibody may help guide cancer search, assist treatment decisions, and predict outcome/relapse. With paraneoplastic myelopathies the initial goal is detection and treatment of the underlying cancer. The aim of immunotherapy in all autoimmune myelopathies is to maximize reversibility, maintain benefits (while preventing relapse), and minimize side effects.

KW - Aquaporin-4-IgG

KW - Autoimmune myelopathy

KW - Neuromyelitis optica

KW - Paraneoplastic myelopathy

KW - Spinal cord sarcoidosis

KW - Transverse myelitis

UR - http://www.scopus.com/inward/record.url?scp=84978438107&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978438107&partnerID=8YFLogxK

U2 - 10.1016/B978-0-444-63432-0.00019-0

DO - 10.1016/B978-0-444-63432-0.00019-0

M3 - Conference contribution

C2 - 27112686

AN - SCOPUS:84978438107

SN - 9780444634320

T3 - Handbook of Clinical Neurology

SP - 327

EP - 351

BT - Autoimmune Neurology, 2016

A2 - Pittock, Sean J.

A2 - Vincent, Angela

PB - Elsevier B.V.

ER -