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Paraneoplastic chronic intestinal pseudo-obstruction

Yusuke Izumi, Takeshi Masuda, Yasushi Horimasu, Taku Nakashima, Shintaro Miyamoto, Hiroshi Iwamoto, Kazunori Fujitaka, Hironobu Hamada, Noboru Hattori
Chronic intestinal pseudo-obstruction (CIPO) is a rare disease with symptoms of ileus without obstruction. Most cases of CIPO are idiopathic, and CIPO as a paraneoplastic neurological syndrome (PNS) associated with small cell lung cancer (SCLC) is rare. A 63-year-old man was diagnosed with functional ileus and confined to bed due to orthostatic hypotension. Chest computed tomography revealed a right hilar mass suspected of being lung cancer. Based on detailed examinations, he was diagnosed with limited-stage SCLC...
October 1, 2017: Internal Medicine
Josephine A Taverna, Hani M Babiker, Seongseok Yun, Maria C Bishop, Sarah Lau-Braunhut, Paul N Meyer, Thomas Enzler
Paraneoplastic syndromes can precede the initial manifestation and diagnosis of cancer. Paraneoplastic syndromes are a heterogeneous group of disorders caused by mechanisms other than the local presence of tumor cells. These phenomena are mediated by humoral factors secreted by tumor cells or by tumor mediated immune responses. Among paraneoplastic syndromes, chronic intestinal pseudo-obstruction (CIPO) is rare and represents a particularly difficult clinical challenge. Paraneoplastic CIPO is a highly morbid syndrome characterized by impaired gastrointestinal propulsion with symptoms and signs of mechanical bowel obstruction...
2014: Biomarker Research
T Leroy, H Porte, C Rousselot, S Taieb, O Outteryck, É Dansin
INTRODUCTION: Anti-Hu antibody syndrome is a paraneoplastic syndrome usually associated with small cell lung carcinoma which induces various symptoms, particularly neurological ones. CASE REPORT: We describe the case of a 49-year old woman with a small cell lung carcinoma who initially experiences a spontaneous regression but then developed neurological symptoms associated with severe autonomic dysfunction manifesting as chronic intestinal pseudo-obstruction and leading finally to hemodynamic failure...
September 2013: Revue des Maladies Respiratoires
Haruki Koike, Gen Sobue
Recent progress in serological screening of paraneoplastic antibodies and in diagnostic imaging techniques to detect malignancies has enabled a broadening of the concept of paraneoplastic neurological syndromes by integrating nonclassic clinical features. The peripheral nervous system is frequently involved in patients with paraneoplastic syndrome and may be seen alone or in combination with involvement of other areas of the nervous system. Destruction of dorsal root ganglion cells due to lymphocytic infiltration, especially with CD8-positive cytotoxic T cells, has been postulated to mediate the classic syndrome of subacute sensory neuronopathy...
2013: Handbook of Clinical Neurology
Liza-Marie Johnson, Holly L Spraker, Jamie L Coleman, Justin N Baker
BACKGROUND: We present a case of severe refractory constipation in an adolescent oncology patient with widely metastatic clear cell osteosarcoma who was ultimately found to have Ogilvie syndrome, also known as acute colonic pseudo-obstruction (ACPO). Ogilvie syndrome is characterized by dilatation of the large intestine in the absence of mechanical obstruction, usually occurring in adult patients with serious underlying medical conditions and rarely seen in children. It is likely that chronic narcotic use, abdominal metastasis, and a paraneoplastic process contributed to development of ACPO in this patient...
September 2012: Journal of Palliative Medicine
Emaddin S Kidher, Natalia Briceno, Ali Taghi, Andrew Chukwuemeka
Paraneoplastic neurological syndromes are conditions that manifest as the remote effects of cancer. These are very rare, occurring in 1/10000 patients with a malignancy, and include Lambert-Eaton myasthenic syndrome, limbic encephalitis, subacute cerebellar ataxia, opsoclonus-myoclonus, Stiff-Person Syndrome, retinopathies, chronic gastrointestinal pseudo-obstruction and sensory neuropathy. This report describes a case of 41-year-old man who presented with elements of multiple paraneoplastic syndromes, including chronic gastrointestinal pseudo-obstruction, myasthenia gravis-Lambert-Eaton overlap syndrome and polymyositis, and who was subsequently found to have a malignant thymoma...
2012: BMJ Case Reports
Ambuga Badari, Deborah Farolino, Eiad Nasser, Shahid Mehboob, David Crossland
Paraneoplastic neurologic syndromes (PNS) are uncommon, affecting fewer than 1 in 10,000 patients with cancer. PNS, while rare, can cause significant morbidity and impose enormous socio-economic costs, besides severely affecting quality of life. PNS can involve any part of the nervous system and can present as limbic encephalitis, subacute cerebellar ataxias, opsoclonus-myoclonus, retinopathies, chronic intestinal pseudo-obstruction (CIPO), sensory neuronopathy, Lambert-Eaton myasthenic syndrome, stiff-person syndrome, and encephalomyelitis...
February 2012: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Daiki Mifune, Hiroko Tsukada, Maki Hosoi, Masaaki Okajima, Akira Yokoyama
A 53-year-old woman with chief complaints of vomiting and constipation was given a diagnosis of ileus and admitted to a local hospital. The origin of the ileus was unknown despite intensive examinations. However, her chest X-ray film and CT showed left hilar and mediastinal lymphadenopathy. Her pro-gastrin-releasing peptide (ProGRP) levels were elevated. After transfer to our hospital, the diagnosis of small cell lung cancer (SCLC) was confirmed by transbronchial aspiration cytology. Since no cause of ileus was found on laparotomy, her symptoms were considered to indicate chronic intestinal pseudo-obstruction (CIPO), a manifestation of paraneoplastic neurological syndrome...
June 2010: Nihon Kokyūki Gakkai Zasshi, the Journal of the Japanese Respiratory Society
Aurelien Amiot, Dominique Cazals-Hatem, Francisca Joly, Anne Lavergne-Slove, Michel Peuchmaur, Yoram Bouhnik, Pierre Bedossa, Bernard Messing
INTRODUCTION: Chronic intestinal pseudoobstruction (CIPO) is classified into enteric visceral myopathies, neuropathies, and/or mesenchymopathies. Although the histology usually permits to highlight pathologic abnormalities of CIPO, it fails in almost a third of cases. The yield of a systematic immunohistochemistry needs to be evaluating. MATERIALS AND METHODS: Twenty-one adult patients with idiopathic CIPO [11 females/10 males, median age 23.1 (0.3 to 57) y] were included and compared with 27 control and 10 with mechanical obstruction patients...
May 2009: American Journal of Surgical Pathology
N Ceze, L D'Alteroche, L Picon, P Magro, C Monégier du Sorbier, E-H Metman
We report a case of a small cell carcinoma of the lung revealed by chronic intestinal pseudo-obstruction associated with achalasia of the lower esophageal sphincter. Tumoral remission was achieved for more than 21 months after chemoradiotherapy but this did not prevent the paraneoplasic syndrome from persisting and medical treatment was not successful in treating the intestinal pseudo-obstruction or the dysphagia, which was not improved by esophageal dilation.
January 2008: Gastroentérologie Clinique et Biologique
A Amiot, F Joly, B Messing, H Sokol, A Lavergne-Slove, J-Y Delattre, Y Bouhnik
Chronic intestinal pseudo-obstruction (CIPO) is a heterogeneous group of rare disorders characterised by symptoms of intestinal obstruction with no mechanical evidence of obstruction. It is caused by ineffective intestinal contractions due to visceral neuropathy and/or neuropathy. In adults, CIPO is mostly secondary. The most common causes are metabolic disorders, connective tissue disorders, neuropathic drug related injuries, paraneoplasic and post-infectious syndromes and amyloidosis. Secondary forms of CIPO have been reported with anti-Hu antibodies...
January 2008: Gastroentérologie Clinique et Biologique
M Nguyen-tat, J Pohl, E Günter, H Manner, N Plum, O Pech, C Ell
Gastroparesis is a common but challenging disorder which can be idiopathic or induced by a variety of underlying diseases, most frequently by diabetes, or post-surgical conditions of the upper abdomen. Clinicians must also consider rare causes of gastric motor dysfunction, such as collagen vascular disorders and paraneoplastic syndromes. Here we present the case of a patient with severe gastroparesis, who was admitted to our hospital for vomiting and weight loss of 25 kg within four months. Endoscopy showed a dilated fluid-filled stomach without peristalsis but no obstruction...
March 2008: Zeitschrift Für Gastroenterologie
Jérôme Honnorat, Jean-Christophe Antoine
Paraneoplastic neurological syndromes (PNS) can be defined as remote effects of cancer that are not caused by the tumor and its metastasis, or by infection, ischemia or metabolic disruptions. PNS are rare, affecting less than 1/10,000 patients with cancer. Only the Lambert-Eaton myasthenic syndrome is relatively frequent, occurring in about 1% of patients with small cell lung cancer. PNS can affect any part of the central and peripheral nervous system, the neuromuscular junction, and muscle. They can be isolated or occur in association...
2007: Orphanet Journal of Rare Diseases
Guido Basilisco, Carlotta Gebbia, Maddalena Peracchi, Pietro Velio, Dario Conte, Nereo Bresolin, Eduardo Nobile-Orazio
A 35-year-old male with an 11-year history of intestinal pseudo-obstruction associated with an idiopathic inflammatory insult of the myenteric plexus and the presence of circulating anti-Hu antibodies developed a neurological syndrome characterized by bilateral hearing loss, deteriorating balance, an unsteady gait and difficulty in estimating distances. A similar neurological syndrome has previously been described in older patients among the paraneoplasic syndromes associated with small-cell lung carcinoma and the presence of circulating anti-Hu antibodies, but never in the rare cancer-free patients with anti-Hu-associated chronic idiopathic intestinal pseudo-obstruction...
April 2005: European Journal of Gastroenterology & Hepatology
Jean-François Viallard, Angela Vincent, Jean-François Moreau, Marie Parrens, Jean-Luc Pellegrin, Emmanuel Ellie
Chronic intestinal pseudo-obstruction can occur as a paraneoplastic disorder, and several cases have been reported in association with thymoma or small-cell lung cancer. Autoantibodies against voltage-gated potassium channels (VGKCs) are found in acquired neuromyotonia (Isaac's syndrome), and have been reported in one case of slow transit constipation without apparent neurological disease. We describe a patient with VGKC antibodies, acquired neuromyotonia and thymoma, who first presented with a severe slow-transit constipation and in whom the gastrointestinal symptoms responded well to plasmapheresis...
2005: European Neurology
I Hirano, J Pandolfino
Chronic intestinal pseudo-obstruction (CIPO) is a syndrome defined by the presence of chronic intestinal dilation and dysmotility in the absence of mechanical obstruction or gross inflammatory disease. Specific diseases may affect any level of the brain-gut axis. For most patients, the diagnosis relies upon a combination of historical, laboratory, manometric and histological features. Recent advances into the autoimmune nature of etiologies such as Chagas' disease and paraneoplastic dysmotility and into the genetic basis of mitochondrial neurogastrointestinal encephalomyopathy, multiple endocrine neoplasia IIB and Hirschsprung's disease have greatly refined our understanding and diagnosis of these disorders...
2000: Digestive Diseases
S L Eck, J H Morse, D A Janssen, S G Emerson, D M Markovitz
Gastrointestinal complaints may be the presenting feature of patients with acquired or hereditary angioedema. We describe two patients with episodic nausea, abdominal pain, and cramping secondary to C1 inhibitor deficiency. In one patient, an acquired deficiency arose as a paraneoplastic syndrome with abdominal complaints preceding the diagnosis of an occult lymphoma. The second patient presented at age 61 with abdominal complaints secondary to a hereditary deficiency of C1 inhibitor. The patients' symptoms were due to gastrointestinal angioedema, resulting from episodic unregulated complement activation...
March 1993: American Journal of Gastroenterology
F Lhermitte, F Gray, O Lyon-Caen, B F Pertuiset, P Bernard
A 67 years old man was admitted on July 1979 for nausea, dysphagia and rectal pain. At age 64 he had undergone radiotherapy on the lower lip for an epidermoid carcinoma. He remained then healthy. His medical history was negative with the exception of chronic bronchitis. He had never been exposed to toxic agents or drugs and had never left Europe. A few days after admission he suffered acute intestinal obstruction but at laparostomy no etiology was found. At the same time the patient complained of pain in all four limbs and he was found to have diffuse wasting of muscles, areflexia and distal sensory loss...
1980: Revue Neurologique
S Anuras
Intestinal pseudo-obstruction is a syndrome of many causes. Attempts must be made to determine the cause and the extent of the involvement of the gastrointestinal tract in each patient, because they will dictate the method of treatment for that patient. Family history must be taken from all primary chronic intestinal pseudo-obstruction patients. If it is positive, genetic counseling and proper medical management can be given to newly identified cases in the family.
1988: Annual Review of Medicine
N Sodhi, M Camilleri, J K Camoriano, P A Low, R D Fealey, M C Perry
This report documents the occurrence of chronic intestinal pseudoobstruction in association with a small cell carcinoma of the lung with evidence of pre- and postganglionic sympathetic dysfunction in one patient with brain metastases, and with sympathetic and parasympathetic postganglionic dysfunction in a second patient. A strategy is outlined for the identification and characterization of disordered neural control of gut motility. This strategy utilizes gastrointestinal motility studies to confirm gut neuropathy, autonomic function tests, and plasma norepinephrine responses to intravenous edrophonium to identify the level of dysfunction...
December 1989: Digestive Diseases and Sciences
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