Atypical Paraneoplastic Neurological Syndrome – a Case Report


Authors: K. Bechyně 1;  D. Rosol 1;  D. Apetauerová 2;  I. Schenk 1
Authors‘ workplace: Neurologické oddělení, Nemocnice Písek, a. s. 1;  Neurology Department Lahey Clinic Burlington MA, USA 2
Published in: Cesk Slov Neurol N 2012; 75/108(3): 359-362
Category: Case Report

Overview

Paraneoplastic syndrome with neurological manifestation results from an immune response to a tumor ectopically expressing a neuronal antigen. A clinical manifestation of neurological paraneoplastic syndrome often precedes the diagnosis of malignancy. Frequently, onconeural antibodies are measured in patients with paraneoplastic syndromes. To some extent, onconeural antibodies may assist in localizing the primary tumor. Over the recent decades, our understanding of pathophysiology of nervous system damage continues to grow, further onconeural antibodies are being identified and new clinical syndromes established. The anti-Yo onconeural antibody has most commonly been associated with paraneoplastic cerebellar degeneration; only a small proportion of patients presents with an involvement of peripheral nervous system. We are describing a case of progressive flaccid paraparesis of lower extremities and endometrial carcinoma. The patient was diagnosed with subacute motor axonal polyneuropathy with the presence of onconeural anti-Yo antibody. We concluded that this was an atypical paraneoplastic neurological syndrome.

Key words:
paraneoplastic neurological syndrome – paraneoplastic polyneuropathy – antibodies


Sources

1. Doležil D, Štourač P. Paraneoplastické postižení nervového systému. In: Havrdová E et al (eds). Neuroimunologie. Praha: Maxdorf 2001: 318–331.

2. Corbo M, Balmaceda C. Peripheral neuropathy in cancer patients. Cancer Invest 2001; 19(4): 369–382.

3. Jaeckle KA. Plexopathies. In: Levin VA (ed). Cancer in the Nervous System. 2nd ed. Oxford: Oxford University Press 2002: 413–422.

4. Jaeckle KA, Young DF, Foley KM. The natural history of lumbosacral plexopathy in cancer. Neurology 1985; 35(1): 8–15.

4. Sutton I, Winer JB. The immunopathogenesis of paraneoplastic neurological syndromes. Clin Sci (Lond) 2002; 102(5): 475–486.

5. Didelot A, Honnorat J. Update on paraneoplastic neurological syndromes. Curr Opin Oncol 2009; 21(6): 566–572.

6. Graus F, Delattre JY, Antoine JC, Dalmau J, Giometto B, Grisold W et al. Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry 2004; 75(8): 1135–1140.

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

8. Bradwell AR. Paraneoplastic neurological syndromes associated with Yo, Hu, and Ri autoantibodies. Clin Rev Allergy Immunol 2000; 19(1): 19–29.

9. Monstad SE, Knudsen A, Salvesen HB, Aarseth JH, Vedeler CA. Onconeural antibodies in sera from pa­tients with various types of tumours. Cancer Immunol Immunother 2009; 58(11): 1795–800.

10. Štourač P, Kadaňka Z. Paraneoplastické neurologické syndromy – protilátkový profil a jeho atypické varianty. Klin Onkol 2000; 13(5): 155–158.

11. Finsterer J, Bodenteich A, Drlicek M. Atypical paraneoplastic syndrome associated with anti-Yo antibodies. Clin Neuropathol 2003; 22(3): 137–140.

12. Konanc DA, O’Neill BP, Caselli RJ, Lennon VA. Peripheral neuropathic presentation in 3 patients with seropositivity for type 1 anti-Purkinje cell antibodies (PCA-1) and ovarian or related Mullerian carcinoma. Neurology 1995; 45 (Suppl 4): A320.

13. Khwaja S, Sripathi N, Ahmad BK, Lennon VA. Paraneoplastic motor neuron disease with type 1 Purkinje cell antibodies. Muscle Nerve 1998; 21(7): 943–945.

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

Issue 3

2012 Issue 3

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