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Paraneoplastic Neurological Syndrome in 64-year-old Patient in Association with a Small Cell Lung Carcinoma


Authors: Z. Prouzová;  S. Brychtová
Authors‘ workplace: Ústav klinické a molekulární patologie LF UP a FN Olomouc
Published in: Klin Onkol 2012; 25(6): 471-475
Category: Case Reports

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Obdrženo: 26. 6. 2012
Přijato: 3. 8. 2012

Overview

Background:
Paraneoplastic neurological syndromes are rare conditions manifest as psychia­tric/neurological symptoms. They are caused by autoimmunne cross-reaction leading to destruction of the central nervous system.

Case:
We present the case of a 64-year-old patient hospitalized for 6 months at the Department of Psychiatry for persisting depression. During that time he progressed to delirium. A diagnosis of diffuse encephalopathy was made, but further examination revealed a small cell lung cancer with generalisation. A paraneoplastic syndrome was finally diagnosed after autoptic and histologic examination.

Conclusion:
Paraneoplastic neurological syndomes can be early signs of malignancy and may considerably precede oncologic diagnosis.

Key words:
paraneoplastic syndromes – Hu antigens – small cell lung carcinoma – cross reactions – paraneoplastic eucephalomyelitis


Sources

1. Posner JB. Paraneoplastic syndromes: a brief review. Ann N Y Acad Sci 1997; 835: 83–90.

2. Denny-Brown D. Primary sensory neuropathy with muscular changes associated with carcinoma. J Neurol Neurosurg Psychiatry 1948; 11(2): 73–87.

3. Henson RA, Hoffman HL, Urich H. Encephalomyelitis with carcinoma. Brain 1965; 88(3): 449–464.

4. Graus F, Saiz A, Dalmau JO. Antibodies and neuronal autoimmune disorders of the CNS. J Neurol 2010; 257(4): 509–517.

5. Dalmau J, Graus F, Cheung NK et al. Major histocompatibility proteins, anti-Hu antibodies, and paraneoplastic encephalomyelitis in neuroblastoma and small cell lung cancer. Cancer 1995; 75(1): 99–109.

6. Kazarian M, Laird-Offringa IA. Small-cell lung cancer-associated autoantibodies: potential applications to cancer diagnosis, early detection, and therapy. Mol Cancer 2011; 10: 33.

7. Antoine J, Mosnier J, Honnorat J et al. Paraneoplastic demyelinating neuropathy, subacute sensory neuropathy, and anti-Hu antibodies: clinicopathological study of an autory case. Muscle Nerve 1998; 21(7): 850–857.

8. Bernal F, Graus F, Pifarré A et al. Immunohistochemical analysis of anti-Hu-associated paraneoplastic encephalomyelitis. Acta Neuropathol 2002; 103(5): 509–515.

9. Croxford AL, Kurschus FC, Waisman A. Mouse models for multiple sclerosis: histological facts and future implications. Biochim Biophys Acta 2011; 1812(2): 177–183.

10. Dalmau J, Posner JB. Paraneoplastic syndromes. Arch Neurol 1999; 56(4): 405–408.

11. Eggers C, Hagel C, Pfeiffer G. Anti-Hu-associated paraneoplastic sensory neuropathy with peripheral nerve demyelination and microvasculitis. J Neurol Sci 1998; 155(2): 178–181.

12. Fahim A, Butt M, McGivern DV. A case of limbic encephalitis presenting as a paraneoplastic manifestation of limited stage small cell lung cancer: a case report. J Med Case Rep 2010; 4: 408.

13. Graus F, Keime-Guibert F, Reñe R et al. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain 2001; 124(Pt 6): 1138–1148.

14. Hiasa Y, Kunishige M, Mitsui T et al. Complicated paraneoplastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer. Clin Neurol Neurosurg 2003; 106(1): 47–49.

15. Jaster JH. Antibodies to Zic4 in paraneoplastic neurologic disorders and small-cell lung cancer. Neurology 2004; 63(7): 1339.

16. Kodousek R, Tichy T. Pathology of paraneoplastic syndromes. Cesk Patol 2000; 36(3): 116–122.

17. Lassmann H, van Horssen J. The molecular basis of neurodegeneration in multiple sclerosis. FEBS Lett 2011; 585(23): 3715–3723.

18. Love S, Louis DN, Ellison DW. Greenfield’s Neuropathology. 8th ed. London: Edward Arnold 2008: 1525–1543.

19. McGuigan C, Bigham S, Johnston D et al. Encephalopathy in a patient with previous malignancy but normal brain imaging. Neurology 2005; 65(1): 165.

20. Oh SJ, Gürtekin Y, Dropcho EJ et al. Anti-Hu antibody neuropathy: a clinical, electrophysioloical, and pathological study. Clin Neurophysiol 2005; 116(1): 28–34.

21. Posner JB. Immunology of paraneoplastic syndromes: overview. Ann N Y Acad Sci 2003; 998: 178–186.

22. Roberts WK, Deluca IJ, Thomas A et al. Patients with lung cancer and paraneoplastic Hu syndrome Harbor HuD-specific type 2 CD8+ T cells. J Clin Invest 2009; 119(7): 2042–2051.

23. Schneider R, Mohebiany AN, Ifergan I et al. B cell-derived IL-15 enhances CD8 T cell cytotoxicity and is increased in multiple sclerosis patients. J Immunol 2011; 187(8): 4119–4128.

24. Tanaka K, Tanaka M, Inuzuka T et al. Cytotoxic T lymfocyte-mediated cell death in paraneoplastic sensory neuronopathy with anti-Hu antibody. J Neurol Sci 1999; 163(2): 156–162.

25. Tofaris GK, Farmer SF. Focal Paraneoplastic Syndrome associated with small cell carcinoma of the lung. J Neurol 2008; 255(1): 123–124.

26. White D, Beringer T. Paraneoplastic limbic encephalitis in an elderly patient with small cell lung carcinoma. Ulster Med J 2010; 79(1): 22–24.

27. Wootla B, Denic A, Keegan B et al. Evidence for the role of B Cells and immunoglobulins in the pathogenesis of multiple sclerosis. Neurol Res Int 2011; 2011: 780712.

Labels
Paediatric clinical oncology Surgery Clinical oncology
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