Long-term clinical outcome of paraneoplastic cerebellar degeneration and anti-Yo antibodies

Rojas, Ingrid Leal; Graus, Francesc; Keime-Guibert, Florence; Rizzoli, René; Delattre, Jean‐Yves; Ramón., José; Dalmau, Josep; Posner, Jerome B.

doi:10.1212/wnl.55.5.713

Cited by 300 publications

(231 citation statements)

References 10 publications

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“…Clinical progression is variable with median survival, as quoted in some studies, is about 100 months for carcinoma breast with PCD [13]. The patient in our report is more in line with the literature.…”

Section: Discussionsupporting

confidence: 90%

Untitled

2016

JNSK

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Paraneoplastic Syndrome, as Paraneoplastic cerebellar degeneration (PCN), in carcinoma breast is a rare entity due to the autoimmune responses. We report a case report of 52 year female with carcinoma breast along with symptoms and signs of cerebellar dysfunction, which on further evaluation is found to be anti-YO autoantibody positive paraneoplastic syndrome. In spite of surgical and chemotherapy patient's neurological condition worsened indicating the poor prognosis of the condition.

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Section: Discussionsupporting

confidence: 90%

Untitled

2016

JNSK

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“…14,25 Detailed analyses of such patients have shown PND to be associated with smaller tumor size, 26,27 limited-stage disease, 17,28 cellular infiltration of tumors, 29 -32 and better cancer prognosis. [33][34][35] Autoimmune PND is observed in Ͻ 1% of patients with SCLC, 25 yet antibodies against the PND-associated, neuroectodermal antigens HuD, ZIC4, recoverin, and VGCC(P/Q-type) have been reported in Յ 25.5%, 16%, 15%, and 5% of patients with SCLC, respectively.…”

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confidence: 99%

Frequency of SOX Group B (SOX1, 2, 3) and ZIC2 antibodies in Turkish patients with small cell lung carcinoma and their correlation with clinical parameters

Vural

Chen

Saip

et al. 2005

Cancer

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BACKGROUNDExpression of neuroectodermal markers is a key feature of small cell lung carcinoma (SCLC). Although immune responses against a number of these proteins have been associated with paraneoplastic neuronal disease (PND), most patients with SCLC have anti‐neuroectodermal antibodies in the absence of PND. Whether these immune responses affect the clinical outcome in SCLC is critical in understanding the potential value of these proteins as cancer vaccine targets as well as in the pathogenesis of PND.METHODSThe authors investigated the frequency of immunoglobulin G autoantibodies against Sry‐like high‐mobility group box (SOX)1, 2, 3 and Zinc‐finger gene of the cerebellum (ZIC)2 proteins in stored serum samples from 90 patients utilizing the λ‐phage plaque assay. Data obtained from patient records were utilized to measure clinical correlates of seroreactivity.RESULTSAntibodies to SOX1 were present in 28% of patients and another 28% had anti‐ZIC2 antibodies, classifying these as some of the most frequent antibody responses observed in SCLC. None had autoimmune paraneoplastic disease. Antibody titers were frequently as high as ≥ 1:106 and were stable for ≤ 6 months after diagnosis. Seroreactivity against either SOX1 or ZIC2 correlated with younger age, lower lactate dehydrogenase levels, and better response to initial therapy.CONCLUSIONSThe frequent and stable presence of SOX Group B and/or ZIC2 antibodies in SCLC, but not in healthy individuals examined, indicates they are serological markers of SCLC. However, the correlation between known clinical parameters of less aggressive disease and seroreactivity suggests that these antibodies are indicators of better prognosis in SCLC and warrants further studies to clarify the nature of the underlying immune responses. Cancer 2005. © 2005 American Cancer Society.

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“…PNS often precedes diagnosis of the tumor by weeks or months [6][7][8]. In our patient, the neurological impairments were apparent 5 months before the detection of gastric cancer.…”

Section: Discussionmentioning

confidence: 74%

Paraneoplastic neurological syndrome in a patient with gastric cancer

et al. 2010

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myasthenic syndrome, which affects approximately 3% of patients with small-cell lung cancer, and myasthenia gravis, which affects 15% of patients with thymoma. For other solid tumors, the incidence of PNS is much less than 1% [2]. Here, we report a rare case of a patient with gastric cancer presenting with primary clinical fi ndings of PNS. Case reportThe patient was a 63-year-old woman with wellcontrolled diabetes and hypertension who presented with sensory disturbance and a feeling of "pins and needles" in her lower distal extremities in May 2007. She was treated with oral medicine and a nerve block injection at a neighborhood clinic, but her condition did not improve. Her neurological disorder became more severe, such that she was unable to walk, and the symptoms spread to the upper extremities. Therefore, she was admitted to our hospital for examination and treatment in September 2007.A neurological examination showed asymmetrical apallesthesia in the lower legs. Severe pain, warmth, and tactile sensations were present below the knees, and her Rankin score was 4 on admission. Sensory nerve conduction study (SCS) showed absent sensory potentials in the bilateral sural nerves and right ulnar nerve when a motor nerve conduction study (MCS) was within normal limits in the bilateral median, ulnar, and tibial nerves (Fig. 1).Laboratory tests showed normal levels of vitamins B1, B2, B6, B12, and E, and folic acid, and no disturbance of electrolyte balance. An elevated titer of antinuclear antibody, of 640 units, was present, but elevated titers of antibodies specifi c for connective tissue disease were not detected. Lumbar puncture showed negative cytology and no infl ammatory changes (such as pleocytosis, intrathecal synthesis of IgG, and oligocloAbstract Paraneoplastic neurological syndromes (PNSs) are a heterogeneous group of neurological disorders caused by immunemediated mechanisms. The incidence of PNS is much less than 1% for solid tumors, except for small-cell lung cancer and thymoma. We report a rare case of gastric cancer that presented with primary clinical fi ndings of PNS. The patient was a 63-year-old woman who was admitted for worsening neuropathy. Laboratory and neurological tests excluded a nutritional defi cit, diabetes mellitus, and connective tissue disease as causes of her neuropathy. Computed tomography (CT) of the abdomen, positron emission tomography (PET)-CT, and endoscopy of the stomach revealed gastric cancer with lymph node swelling. Distal gastrectomy was performed and pathological and immunohistochemical examinations indicated endocrine cell carcinoma. The gastrectomy stopped the exacerbation of her symptoms and recurrence was not observed, but the neurological disorders were irreversible. This case suggests that early diagnosis of the primary tumor is required to improve the outcome in patients with PNS.

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Long-term clinical outcome of paraneoplastic cerebellar degeneration and anti-Yo antibodies

Cited by 300 publications

References 10 publications

Untitled

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Frequency of SOX Group B (SOX1, 2, 3) and ZIC2 antibodies in Turkish patients with small cell lung carcinoma and their correlation with clinical parameters

Paraneoplastic neurological syndrome in a patient with gastric cancer

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