Chronic multiple paraneoplastic syndromes

Kleopa, Kleopas A.; Teener, James W.; Scherer, Steven S.; Galetta, Steven; Bird, Shawn J.

doi:10.1002/1097-4598(200011)23:11<1767::aid-mus16>3.0.co;2-a

Cited by 17 publications

(17 citation statements)

References 27 publications

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“…It has previously been reported that patients may have several paraneoplastic syndromes or multiple autoantibodies [9,19]. Both immunohistochemistry and immunoblot may identify several different antibodies in one assay, whereas this is not possible by ITT immunoprecipitation based on one antigen.…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic antibodies against HuD detected by a sensitive radiobinding assay

Storstein

Monstad

Nakkestad

et al. 2004

Journal of Neurology

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Patients with paraneoplastic encephalomyelitis(subacute sensory neuronopathy) (PEM/SSN), most commonly associated with small-cell lung cancer (SCLC), frequently harbor Hu antibodies, which are usually detected by indirect immunohistochemistry or immunoblot. We developed a new radioimmunobinding assay to detect Hu antibodies based on in vitro transcribed and translated (ITT) HuD. High levels of Hu antibodies were detected in all seven PEM/SSN patients tested, but not in any of 15 patients with other paraneoplastic syndromes, 20 patients with Sjögren's syndrome, 20 patients with miscellaneous tumors and 99 of 100 blood donors. One of the blood donors had low levels of Hu antibodies. The radiobinding assay detected Hu antibodies in 45 of 191 (24%) patients with SCLC, in comparison with immunofluorescence and immuno dot blot, where only 34 of 191 (18%) were detected. All patients with Hu antibodies detected by immunofluorescence and immuno dot-blot were also positive by the radioimmunobinding assay. The results demonstrate that this assay is very specific and sensitive for the detection of Hu antibodies.

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Section: Discussionmentioning

confidence: 99%

Paraneoplastic antibodies against HuD detected by a sensitive radiobinding assay

Storstein

Monstad

Nakkestad

et al. 2004

Journal of Neurology

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“…VGCC antibodies had been described to be recognized in 41% of patients with paraneoplastic cerebellar degeneration and SCLC [5]. However, patients with SCLC who have PLE have been rarely reported in the English literature, moreover, only four patients yielded a positive finding of VGCC antibody including our present case [6-8]. Although the reason for the preferential association of PLE with SCLC is unclear, several researchers hypothesize a mechanism whereby the tumor expression of brain proteins is the trigger of autoimmunity against the nervous system [1].…”

Section: Discussionmentioning

confidence: 50%

“…Our patient also has a negative anti-Hu antibody; therefore, his neurological symptoms may improve after systemic chemotherapy. Furthermore, recent reports had documented that some neurological symptoms were improved after systemic treatment in patients with SCLC with VGCC antibody-positive PLE [1,6-8]. However, it remains unknown whether the presence of VGCC antibody is correlated with a good response to therapy.…”

Section: Discussionmentioning

confidence: 99%

Small-cell lung cancer with voltage-gated calcium channel antibody-positive paraneoplastic limbic encephalitis: a case report

et al. 2014

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IntroductionParaneoplastic limbic encephalitis is a rare neurological syndrome and clinically characterized by cognitive dysfunction, memory impairment, seizures and psychiatric symptoms. Paraneoplastic limbic encephalitis is most frequently found in small-cell lung cancer, among various malignancies, and antineuronal antibodies are related to the autoimmune mechanism. We experienced a rare case of a patient with small-cell lung cancer with anti-voltage-gated calcium channel antibody-positive paraneoplastic limbic encephalitis.Case presentationA 61-year-old Japanese man with a history of smoking cigarettes presented with seizure, confusion and personality change in acute onset. Brain magnetic resonance imaging showed high signal intensity on T2-weighted image in his right temporal lobe, suggestive of limbic encephalitis. A mediastinoscopy of the lymph node revealed small-cell lung carcinoma, and he was staged as having limited stage disease. Antibodies against P/Q-type and N-type voltage-gated calcium channel were positive and Hu antibody was negative. He was started on chemotherapy of carboplatin plus etoposide with concurrent thoracic radiotherapy. Neurological symptoms were gradually improved after systemic chemotherapy.ConclusionsWe should be alert to the potential of malignant neoplasms associated with paraneoplastic limbic encephalitis when we examine a patient with cancer with neurological disorders such as personality change, disorientation, unconsciousness and memory loss. A clinical marker such as voltage-gated calcium channel antibody may help our diagnosis in clinical practice.

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“…1,5,9,10,22,35,59 -63 In this patient, the association of MG with a highly malignant smooth-muscle tumor and VGCCs paraneoplastic antibodies point to the possibility of a paraneoplastic overlap myasthenic syndrome and perhaps what may be a paraneoplastic neuropathy related to the uterine/abdomen malignant tumor. 40 A chest CT scan and chest films were performed to screen for primary or metastatic lung tumors; none was found. Other lung tumor markers, anti-HU and CEA were not present.…”

Section: Discussionmentioning

confidence: 99%

A Diagnostic and Management Dilemma

Roohi¹,

Smith²,

Bergman³

et al. 2006

The Neurologist

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To our knowledge, this is the first report of overlap myasthenic syndrome in conjunction with abdominal leiomyosarcoma. The immunologic coexistence of acquired myasthenia gravis and Lambert-Eaton myasthenic syndrome in a patient with a malignant smooth-muscle tumor is intriguing and suggests that a common paraneoplastic process targeting 2 different onconeural antigens was the underlying pathogenic mechanism in this patient.

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Chronic multiple paraneoplastic syndromes

Cited by 17 publications

References 27 publications

Paraneoplastic antibodies against HuD detected by a sensitive radiobinding assay

Paraneoplastic antibodies against HuD detected by a sensitive radiobinding assay

Small-cell lung cancer with voltage-gated calcium channel antibody-positive paraneoplastic limbic encephalitis: a case report

A Diagnostic and Management Dilemma

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