Demyelinating Neuropathy and Autoimmune Hemolytic Anemia in a Patient with Pancreatic Cancer

Koike, Haruki; Yoshida, Hitoshi; Ito, Takahiko; Ohyama, Ken; Hashimoto, Rina; Kawagashira, Yuichi; Iijima, Masahiro; Sobue, Gen

doi:10.2169/internalmedicine.52.9577

Cited by 9 publications

(7 citation statements)

References 23 publications

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“…Other solid tumours associated with AIHA were essentially lung, kidneys and colorectal cancers and Kaposi syndrome 3. In addition to previously cited case, AIHA related to pancreatic cancer was reported, to our knowledge, in only another case of a 71-year-old man presenting pancreatic adenocarcinoma with demyelinating neuropathy and AIHA, confirming the rarity of such paraneoplastic syndrome 11…”

Section: Discussionsupporting

confidence: 70%

Autoimmune haemolytic anaemia in pancreatic adenocarcinoma: a potential paraneoplastic presentation

et al. 2019

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While autoimmune haemolytic anaemia (AIHA) is a well-known paraneoplastic syndrome in haematological malignancies, it has been described far less in solid tumours. We hereby report the case of a 61-year-old male patient presenting AIHA related to pancreatic cancer. Investigations excluded infectious, autoimmune and toxic causes of AIHA. CT of the abdomen highlighted the presence of hypodense, infiltrating mass of the tail of the pancreas measuring 70×37×36 mm, compatible with pancreas neoplasm. Histological examination of two associated nodular lesions of the liver showed metastasis of pancreatic adenocarcinoma. The patient was started on corticosteroid without improvement of haemoglobin. Palliative chemotherapy was initiated; this led to significant improvement in haemoglobin comforting our diagnosis. This case illustrates the rare association between AIHA and pancreatic cancer. However, such association cannot be considered before excluding other, more frequent, aetiologies.

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Section: Discussionsupporting

confidence: 70%

Autoimmune haemolytic anaemia in pancreatic adenocarcinoma: a potential paraneoplastic presentation

et al. 2019

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“…In as much as 7% of patients with various solid tumors including pancreatic cancer, disseminated intravascular coagulation is observed [21] which can lead to hemolytic anemia potentially reducing hemoglobin levels. Hemolytic anema cases in pancreatic cancers have been reported [22]. On the other hand Claspin had higher levels in HG compared to controls and it was also high in LG and IPMNC.…”

Section: Discussionmentioning

confidence: 92%

Label-free serum proteomics and multivariate data analysis identifies biomarkers and expression trends that differentiate Intraductal papillary mucinous neoplasia from pancreatic adenocarcinoma and healthy controls

et al. 2019

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Background: Intraductal Papillary Mucinous Neoplasia (IPMN) are potentially malignant cystic tumors of the pancreas. IPMN can progress from low to moderate to high grade dysplasia and further to IPMN associated carcinoma. Often the difference between benign and malignant nature of the IPMN is not clear preoperatively. We aim to elucidate molecular expression patterns of various grades of IPMN and pancreatic carcinoma. Additionally we suggest potential novel biomarkers to differentiate IPMN from healthy individuals and pancreatic carcinoma to enable early detection as well as help in differential diagnosis in future. Methods: We have performed retrospective label-free proteomic analysis of the serum samples from 44 patients with various grades of benign IPMN or IPMN associated carcinoma and 11 healthy controls. Proteomic data was further analyzed by various multivariate statistical methods. Four groups of samples (low-grade, high-grade IPMN, pancreatic carcinoma and age-and sex-matched healthy controls) were compared with ANOVA. Orthogonal projections to latent structures-discriminant analysis (OPLS-DA) modeling gave S-plot for feature selection. Stringently selected potential markers were further evaluated with ROC curve analysis and area under the curve was calculated. Differentially expressed proteins were used for pathway analysis. Linear trend analysis (Mann Kendall test) was used for identifying significant increasing or decreasing trends from healthy-low grade-high grade IPMN-pancreatic carcinoma.

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“…Management of pain as a result of paraneoplastic neuropathy does not differ from the published guidelines on the management of neuropathic pain [ 50 ]. However, it is commonly reported that treatment for the underlying malignancy (including tumor resection and/or chemotherapy) can improve the symptoms [ 3 , 11 , 28 , 30 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis

et al. 2017

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IntroductionParaneoplastic neurological syndromes (PNS) consist of a heterogeneous group of neurological disorders triggered by cancer. The aim of this systematic review is to estimate the reported prevalence of pain in patients with paraneoplastic peripheral neuropathy (PPN).MethodsA systematic computer-based literature search was conducted on PubMed database.ResultsOur search strategy resulted in the identification of 126 articles. After the eligibility assessment, 45 papers met the inclusion criteria. Full clinical and neurophysiological data were further extracted and involved 92 patients with PPN (54.5% males, mean age 60.0 ± 12.2 years). The commonest first manifestation of PPN is sensory loss (67.4%), followed by pain (41.3%), weakness (22.8%), and sensory ataxia (20.7%). In 13.0% of the cases, pain was the sole first manifestation of the PPN. During the course of the PPN, 57.6% of the patients may experience pain secondary to the neuropathy.ConclusionsPain is very prevalent within PPN. Pain specialists should be aware of this. Detailed history-taking, full clinical examination, and requesting nerve conduction studies might lead to an earlier diagnosis of an underlying malignancy.

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Demyelinating Neuropathy and Autoimmune Hemolytic Anemia in a Patient with Pancreatic Cancer

Cited by 9 publications

References 23 publications

Autoimmune haemolytic anaemia in pancreatic adenocarcinoma: a potential paraneoplastic presentation

Autoimmune haemolytic anaemia in pancreatic adenocarcinoma: a potential paraneoplastic presentation

Label-free serum proteomics and multivariate data analysis identifies biomarkers and expression trends that differentiate Intraductal papillary mucinous neoplasia from pancreatic adenocarcinoma and healthy controls

Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis

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