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Late post-transplant anti-aquaporin-4 Ab-positive optic neuritis in a patient with AML

Bone Marrow Transplantation volume 50, pages 1125–1126 (2015)Cite this article

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Seropositivity for anti-aquaporin-4 Abs (AQP-4-IgG) marks severe forms of optic neuritis (ON), which are part of the so-called neuromyelitis optica spectrum disorders (NMOSD), and can remain isolated or evolve into the complete phenotype of the spectrum, namely, neuromyelitis optica (NMO).1, 2 AQP-4-IgG play a pivotal diagnostic role, as they are directly involved in the pathogenetic mechanisms of NMOSD.3 The dysregulation of the immune system that likely underlies the pathogenesis of NMOSD also accounts for the frequent association of these disorders with other organ- and non-organ specific autoimmune diseases.2 Allogeneic bone marrow transplantation (allo-BMT) after myeloablative conditioning is a current, effective treatment for many hematologic malignancies. In post-transplant patients, neurologic complications, which include posterior reversible encephalopathy, seizures, encephalopathy, polyneuropathy and central nervous system (CNS) infections, are described, but CNS immune-mediated demyelinating diseases (IMDD), either primary4 or secondary to chronic GvHD,5 are rare.

We report on a patient who developed AQP-4-IgG-associated ON, after allo-BMT for AML.

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Acknowledgements

This work was supported by the Italian Ministry of Health, research grant RF 2011–2012 no. 2534459.

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Authors and Affiliations

  1. Neuroscience Consortium, University of Pavia, Monza Policlinico and Pavia Mondino, Pavia, Italy

    L Diamanti & G Berzero

  2. IRCCS, ‘C. Mondino’ National Neurological Institute, Pavia, Italy

    L Diamanti, D Franciotta, G Berzero, P Bini, L M Farina, M Ceroni & E Marchioni

  3. Department of Hematology and Oncology, Transplantation Unit, IRCCS, Policlinico San Matteo, Pavia, Italy

    A A Colombo

  4. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

    M Ceroni

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  1. L Diamanti
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  2. D Franciotta
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  3. G Berzero
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Correspondence to L Diamanti.

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Diamanti, L., Franciotta, D., Berzero, G. et al. Late post-transplant anti-aquaporin-4 Ab-positive optic neuritis in a patient with AML. Bone Marrow Transplant 50, 1125–1126 (2015). https://doi.org/10.1038/bmt.2015.84

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