Pulmonary Nodular Lymphoid Hyperplasia in a Case of Overlapping Neuromyelitis Optica Spectrum Disorder and Myasthenia Gravis

Q4 Immunology and Microbiology

Clinical and Experimental Neuroimmunology Pub Date : 2025-05-15 DOI:10.1111/cen3.70013

Masashi Higashino, Juichi Fujimori, Takanobu Sasaki, Takafumi Sugawara, Fumiyoshi Fujishima, Kimihiko Kaneko, Ichiro Nakashima

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Abstract

Background

Anti-aquaporin 4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory autoimmune astrocytopathy. While the precise mechanism of autoantibody production has not been completely elucidated, most AQP4-IgG is believed to originate in the peripheral lymphoid tissue.

Case Presentation

Herein, we present a rare case of overlapping anti-AQP4 antibody-positive NMOSD and anti-acetylcholine receptor (anti-AChR) antibody-positive myasthenia gravis (MG), incidentally accompanied by pulmonary nodular lymphoid hyperplasia (NLH), a condition also observed in several cases with Sjögren's syndrome.

Conclusions

The present case suggests that NLH, which may have been overlooked, can be found in NMOSD and MG. Although NLH was not considered a source of pathological autoantibodies, further analysis is required to clarify whether NLH is involved in the pathogenesis of chronic inflammatory conditions.

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重叠神经脊髓炎、视谱障碍和重症肌无力合并肺结节性淋巴样增生1例

抗水通道蛋白4 （AQP4）抗体阳性的视神经脊髓炎谱系障碍（NMOSD）是一种神经炎性自身免疫性星形细胞病。虽然自身抗体产生的确切机制尚未完全阐明，但大多数AQP4-IgG被认为起源于外周淋巴组织。在此，我们报告一例罕见的重叠抗aqp4抗体阳性的NMOSD和抗乙酰胆碱受体（抗achr）抗体阳性的重症肌无力（MG），偶然伴有肺结节性淋巴样增生（NLH），这种情况也在Sjögren综合征的几个病例中观察到。结论本病例提示，NMOSD和MG可能存在被忽视的NLH。虽然NLH不被认为是病理性自身抗体的来源，但需要进一步的分析来阐明NLH是否参与慢性炎症的发病机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Neuroimmunology Immunology and Microbiology-Immunology and Microbiology (miscellaneous)

CiteScore

1.60

自引率

0.00%

发文量