Paraneoplastic myelopathy, neural autoantibody positive (Q100600)

Paraneoplastic myelopathy seropositive for neural autoantibodies. When these neural antibodies target plasma membrane antigens they are effectors of injury (e.g. neuromyelitis optica, which may rarely present as a paraneoplastic phenomenon with aquaporin-4 antibody seropositivity) through multiple effector mechanisms. However, when targeting nuclear or cytoplasmic antigens (e.g. amphiphysin-IgG or collapsin response mediator protein-5-IgG [CRMP5-IgG or anti-CV2) they are markers of a T-cell effector mediated injury as they are inaccessible to immune attack in situ, but peptides from intracellular proteins are displayed on upregulated MHC class 1 molecules in a pro-inflammatory cytokine milieu and then accessible to peptide specific cytotoxic T-cells.