Syndrome of Inappropriate Antidiuretic Hormone Secretion as the Initial Presentation in a Patient with Stage I Small-cell Lung Cancer

Koizumi, Tomonobu; Kobayashi, Takashi; Kanda, Shintaro; Fukushima, Toshirou; Muranaka, Futoshi; Miura, Kentaro; Asaka, Shiho

doi:10.2169/internalmedicine.8223-21

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…In addition, hyponatraemia is a common paraneoplastic syndrome caused by ectopic secretion of small cell lung cancer [16]. Tomonobu Koizumi et al [17] reported that about approximately 9%~15% of patients with small cell lung cancer had combined hyponatremia, which is usually closely related to the ectopic secretion of antidiuretic hormone by paraneoplastic tumours. Recalcitrant hyponatremia secondary to abnormal secretion of antidiuretic hormone (SIADH) is an independent risk factor for poor prognosis in patients with malignant tumours [17,18], and timely sodium supplementation therapy can signi cantly improve the survival prognosis of patients.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune encephalitis with coexisting antibodies to GABABR, GAD65, SOX1 and Ma2

Li,

Yang,

et al. 2024

Preprint

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Background Autoimmune encephalitis (AE) refers to a heterogeneous group of CNS autoimmune disorders characterized by the production of different anti-neuronal surface synaptic protein-associated antibodies. In recent years, autoimmune encephalitis that is positive for multiple anti-neuronal antibodies has been gradually recognized in the clinic, with complex and varied clinical manifestations, especially in combination with malignant tumours, which have worse treatment and prognosis. Current clinical studies on the coexistence of multiple anti-neuronal antibodies in patients with AE are mainly disseminated case reports. Patients with AE in which four anti-neuronal antibodies coexist are even rarer. Case presentation: We report a patient who initially presented with small cell lung cancer and hyponatraemia, followed by seizures and progressive deterioration of consciousness, cognition and psychiatric abnormalities. A cell-based assay (CBA) method was used to detect serum and cerebrospinal fluid anti-neuronal surface or prominent protein antibodies. Patients with AE diagnosed with co-existing anti-GABABR, GAD65, SOX1 and Ma2 antibodies and receiving gammaglobulin, steroid shock therapy, and chemotherapy for small cell lung cancer. Conclusions The coexistence or overlap of multiple anti-neuronal surface antibodies with anti-neuronal intracellular antibodies is rare and increases the likelihood of underlying malignancy. Elucidating the impact of individualised immunotherapy and coexisting antibodies on the clinical presentation of patients has the potential to improve long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Autoimmune encephalitis with coexisting antibodies to GABABR, GAD65, SOX1 and Ma2

Li,

Yang,

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Autoimmune encephalitis with coexisting antibodies to GABABR, GAD65, SOX1 and Ma2

Li,

Yang,

et al. 2024

BMC Neurol

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Background Autoimmune encephalitis (AE) is a disease caused by an abnormal reaction between the body’s autoimmunity and the central nervous system, in which the abnormal immune response targets antigenic components within or on the surface of neuronal cells. The main manifestations are mental and behavioural changes, cognitive impairment, impaired consciousness, seizures, movement disorders, etc. Most cell surface antibodies respond well to immunotherapy, intracellular antibodies, on the other hand, are usually associated with more tumours and are relatively difficult to treat with a poor prognosis. In recent years, autoimmune encephalitis that is positive for multiple anti-neuronal antibodies has been gradually recognized in the clinic, with complex and varied clinical manifestations, especially in combination with malignant tumours, which have worse treatment and prognosis. Current clinical studies on the coexistence of multiple anti-neuronal antibodies in patients with AE are mainly disseminated case reports. Patients with AE in which four anti-neuronal antibodies coexist are even rarer. Case presentation We report a patient who initially presented with an irritating dry cough and hyponatraemia and a chest CT suspicious for malignancy, followed by progressive deterioration of persistent status epilepticus, consciousness and cognitive deficits, and psycho-behavioural abnormalities. Serum and cerebrospinal fluid antibodies against neuronal surface or intracellular antigens were detected using a cell-based assay (CBA) method. Serum and cerebrospinal fluid were found to be positive for anti-GABABR, GAD65, SOX1 and Ma2 antibodies. And a definitive diagnosis of small cell lung cancer was made by immunohistochemistry. He eventually received gammaglobulin, steroid pulsed therapy and tumour chemotherapy. Conclusions The coexistence or overlap of multiple anti-neuronal surface antibodies with anti-neuronal intracellular antibodies is rare and increases the likelihood of underlying malignancy. Elucidating the impact of individualized immunotherapy and coexisting antibodies on the clinical presentation of patients has the potential to improve long-term prognosis.

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Syndrome of Inappropriate Antidiuretic Hormone Secretion as the Initial Presentation in a Patient with Stage I Small-cell Lung Cancer

Cited by 2 publications

References 13 publications

Autoimmune encephalitis with coexisting antibodies to GABABR, GAD65, SOX1 and Ma2

Autoimmune encephalitis with coexisting antibodies to GABABR, GAD65, SOX1 and Ma2

Autoimmune encephalitis with coexisting antibodies to GABABR, GAD65, SOX1 and Ma2

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