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https://www.readbyqxmd.com/read/28546233/a-case-of-confusion-paraneoplastic-encephalomyelitis-in-an-elderly-patient-suspected-of-having-urinary-tract-infection-associated-delirium
#1
Chris McKinnon, Simmie Manchanda
Acute confusion is a common symptom of physical illness in the older patient. In the majority, it is transient and resolves on treatment of precipitants. In a subset of patients, however, neurological decline is progressive, raising concern about a serious underlying cause. We describe the case of a 71-year-old woman who developed progressive cognitive impairment following insertion of a permanent pacemaker for sinoatrial arrests. An initial diagnosis of delirium secondary to a urinary tract infection was suspected; however, the patient became increasingly confused despite treatment...
May 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28413671/paraneoplastic-limbic-encephalitis-in-a-patient-with-extensive-disease-small-cell-lung-cancer
#2
Sebastian Ochenduszko, Bartosz Wilk, Joanna Dabrowska, Izabela Herman-Sucharska, Anna Dubis, Miroslawa Puskulluoglu
Paraneoplastic limbic encephalitis (PLE) is a rare disorder infrequently accompanying malignancy, coexisting in ~50% of the cases with small-cell lung cancer (SCLC). The pathomechanism of PLE is considered to be immune-mediated, with production of specific anti-Hu antibodies and activation of T-cells directed against onconeural antigens present on both tumor cells and neurons. We herein report the case of a 50-year-old male patient who, prior to being diagnosed with SCLC, presented with typical symptoms of PLE (seizures, subacute cognitive dysfunction with severe memory impairment, anxiety and hallucinations)...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28256369/anti-hu-paraneoplastic-brainstem-encephalitis-caused-by-a-pancreatic-neuroendocrine-tumor-presenting-with-central-hypoventilation
#3
Marc Najjar, Andrew Taylor, Surbhi Agrawal, Tito Fojo, Alexander E Merkler, Marc K Rosenblum, Laura Lennihan, Michael D Kluger
Paraneoplastic neurological syndromes are rare autoimmune manifestations of malignancies associated with specific antibodies. Anti-Hu associated brainstem encephalitis, a well-described syndrome, usually presents subacutely with preferential involvement of the medulla. Anti-Hu antibodies target intraneuronal antigens and are therefore highly correlated with neurological syndromes when present concomitantly with a neoplasm. Reported is a case of anti-Hu brainstem encephalitis associated with a pancreatic neuroendocrine tumor (PNET) presenting with central hypoventilation...
February 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28166327/neurological-autoantibody-prevalence-in-epilepsy-of-unknown-etiology
#4
Divyanshu Dubey, Abdulradha Alqallaf, Ryan Hays, Matthew Freeman, Kevin Chen, Kan Ding, Mark Agostini, Steven Vernino
Importance: Autoimmune epilepsy is an underrecognized condition, and its true incidence is unknown. Identifying patients with an underlying autoimmune origin is critical because these patients' condition may remain refractory to conventional antiseizure medications but may respond to immunotherapy. Objective: To determine the prevalence of neurological autoantibodies (Abs) among adult patients with epilepsy of unknown etiology. Design, Setting, and Participants: Consecutive patients presenting to neurology services with new-onset epilepsy or established epilepsy of unknown etiology were identified...
April 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28074593/microtubule-associated-protein-1b-novel-paraneoplastic-biomarker
#5
Avi Gadoth, Thomas J Kryzer, Jim Fryer, Andrew McKeon, Vanda A Lennon, Sean J Pittock
OBJECTIVE: To report the identification of microtubule-associated protein (MAP) 1B as the antigen of the previously described Purkinje cell cytoplasmic antibody type 2 (PCA-2) antibody, its frequency, and clinical, oncological, and serological associations. METHODS: Archival serum or cerebrospinal fluid (CSF) specimens were available from 96 of 118 consecutive PCA-2-IgG-seropositive patients identified during 1993-2016. The autoantigen, defined in mouse brain lysate by Western blot and mass spectrometry, was confirmed by dual immunohistochemical staining using commercial antibodies...
February 2017: Annals of Neurology
https://www.readbyqxmd.com/read/27905561/anti-hu-antibodies-activate-enteric-and-sensory-neurons
#6
Qin Li, Klaus Michel, Anita Annahazi, Ihsan E Demir, Güralp O Ceyhan, Florian Zeller, Lars Komorowski, Winfried Stöcker, Michael J Beyak, David Grundy, Gianrico Farrugia, Roberto De Giorgio, Michael Schemann
IgG of type 1 anti-neuronal nuclear antibody (ANNA-1, anti-Hu) specificity is a serological marker of paraneoplastic neurological autoimmunity (including enteric/autonomic) usually related to small-cell lung carcinoma. We show here that IgG isolated from such sera and also affinity-purified anti-HuD label enteric neurons and cause an immediate spike discharge in enteric and visceral sensory neurons. Both labelling and activation of enteric neurons was prevented by preincubation with the HuD antigen. Activation of enteric neurons was inhibited by the nicotinic receptor antagonists hexamethonium and dihydro-β-erythroidine and reduced by the P2X antagonist pyridoxal phosphate-6-azo (benzene-2,4-disulfonic acid (PPADS) but not by the 5-HT3 antagonist tropisetron or the N-type Ca-channel blocker ω-Conotoxin GVIA...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27707529/antineuronal-nuclear-autoantibody-type-1-anti-hu-associated-opsoclonus-myoclonus-and-epilepsia-partialis-continua-case-report-and-literature-review
#7
Michael Sweeney, Matthew Sweney, M Mateo Paz Soldán, Stacey L Clardy
BACKGROUND: Opsoclonus-myoclonus syndrome is a rare clinical condition that has been associated with neuroblastoma. There are few reported examples of ANNA-1/anti-Hu antibodies in children with neuroblastoma and opsoclonus-myoclonus, all in children aged less than three years of age. METHODS: We describe the new onset of focal seizures without alteration of consciousness and opsoclonus-myoclonus in an 11-year-old girl with ANNA-1/anti-Hu positivity and a paraspinal ganglioneuroblastoma...
December 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27686499/maternal-antineuronal-antibodies-and-risk-of-childhood-autism-spectrum-disorders-a-case-control-study
#8
Naael H Ali, Shukrya K Khalaf, Jasim N Al-Asadi, Alaa H Abed
BACKGROUND: The etiology of autism is complex, and may involve the interaction between genetic and environmental factors. Recent studies suggested an association between maternal immune response and this disorder. METHODS: Forty-nine women with autistic children (cases) were studied in comparison with 73 women with normal children (controls). After interviewing for sociodemographic and clinical information, mothers' sera were tested for the presence of antineuronal antibodies...
December 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27668114/bilateral-vocal-cord-paralysis-and-cervicolumbar-radiculopathy-as-the-presenting-paraneoplastic-manifestations-of-small-cell-lung-cancer-a-case-report-and-literature-review
#9
Jeffrey C Yeung, C Elizabeth Pringle, Harmanjatinder S Sekhon, Shaun J Kilty, Kristian Macdonald
Introduction. Bilateral vocal cord paralysis (BVCP) is a potential medical emergency. The Otolaryngologist plays a crucial role in the diagnosis and management of BVCP and must consider a broad differential diagnosis. We present a rare case of BVCP secondary to anti-Hu paraneoplastic syndrome. Case Presentation. A 58-year-old female presented to an Otolaryngology clinic with a history of progressive hoarseness and dysphagia. Flexible nasolaryngoscopy demonstrated BVCP. Cross-sectional imaging of the brain and vagus nerves was negative...
2016: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/27629954/paraneoplastic-limbic-encephalitis-in-a-human-epidermal-growth-factor-receptor-2-positive-gastric-cancer-patient-treated-with-trastuzumab-combined-chemotherapy-a-case-report-and-literature-review
#10
REVIEW
Yu Uneno, Akira Yokoyama, Yoshitaka Nishikawa, Taro Funakoshi, Yoshinao Ozaki, Ikuo Aoyama, Kiichiro Baba, Daisuke Yamaguchi, Shuko Morita, Yukiko Mori, Masashi Kanai, Hisanori Kinoshita, Takeshi Inoue, Nobukatsu Sawamoto, Riki Matsumoto, Shigemi Matsumoto, Manabu Muto
Paraneoplastic neurological syndromes (PNSs) are rare nervous system dysfunctions in cancer patients, which are primarily observed with small-cell lung cancer, gynecological cancer, and thymoma. We herein present an uncommon case of PNS in an anti-Hu antibody-positive patient with human epidermal growth factor receptor (HER)-2-positive gastric cancer (GC), who developed limbic encephalitis and a worsening cognitive function. Trastuzumab-combined chemotherapy was initiated and appeared to be partially effective for controlling the neurological symptoms and tumor volume...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27558994/pulvinar-sign-in-a-case-of-anti-hu-paraneoplastic-encephalitis
#11
Pierre-Luc Gamache, Maude-Marie Gagnon, Martin Savard, François Émond
This article reports the case of a 68-year-old patient with anti-HU antibodies paraneoplastic encephalitis. The clinical manifestations were atypical and the paraclinical work-up, notably the magnetic resonance imaging (MRI) showing bilateral posterior thalamic hyperintensities (pulvinar sign), misleadingly pointed towards a variant Creutzfeld-Jakob disease. After presenting the case, the differential diagnosis of the pulvinar sign is discussed along with other important diagnostic considerations.
December 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27515847/intrathecal-synthesis-of-anti-hu-antibodies-distinguishes-patients-with-paraneoplastic-peripheral-neuropathy-and-encephalitis
#12
Philipp Schwenkenbecher, Lisa Priya Chacko, Ulrich Wurster, Kaweh Pars, Refik Pul, Kurt-Wolfram Sühs, Martin Stangel, Thomas Skripuletz
BACKGROUND: Paraneoplastic syndromes are serious immune caused diseases of the peripheral and/or central nervous system associated with malignant neoplasm. Symptoms develop when antibodies against antigens expressed by tumor cells cross-react with neuronal proteins. Antineuronal antibodies are usually examined in patient's sera while examination of the cerebrospinal fluid (CSF) often fails. Furthermore, the few previous reports describing CSF data summarized different antineuronal antibodies and/or regarded patients with different neurological symptoms as one group...
August 11, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27329274/paraneoplastic-opsoclonus-myoclonus-ataxia-syndrome-revealing-dual-malignancy
#13
A Nasri, I Kacem, F Jerdak, M Ben Djebara, N Mejri, Y Sidhom, A Gargouri, Riadh Gouider
Dual malignancy has been rarely associated to paraneoplastic syndromes. We describe an unusual case of metachronous small cell lung carcinoma revealed by opsoclonus-myoclonus ataxia syndrome in a 69-year-old patient with known prostate adenocarcinoma, with positive anti-Hu and anti-Yo antibodies and good responsiveness to corticosteroids and chemotherapy.
October 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27301520/brachial-diparesis-due-to-motor-neuronopathy-as-one-of-the-predominant-presenting-signs-of-occult-small-cell-lung-carcinoma
#14
Sefik Evren Erdener, Atay Vural, Cagri Mesut Temucin, Sevim Erdem Ozdamar, Gulay Nurlu, Kubilay Varli, Nese Dericioglu
Sensory neuronopathy is a well-established presentation in paraneoplastic neurological syndromes that is mostly associated with small cell lung cancer and anti-Hu antibodies. Motor neuronopathy, on the other hand, is an extremely rare observation in this syndrome. A 56-year-old man presented with asymmetric brachial diparesis and sensory ataxia. Electrophysiological studies revealed sensory ganglionopathy and progressive anterior horn degeneration in cervical segments. Small cell lung carcinoma with associated anti-Hu antibodies was later diagnosed...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27235344/screening-for-anti-titin-antibodies-in-patients-with-various-paraneoplastic-neurological-syndromes
#15
Benjamin Berger, Oliver Stich, Siegfried Labeit, Sebastian Rauer
Anti-titin antibodies indicate a paraneoplastic etiology pointing towards a thymoma in myasthenia gravis (MG), but their seroprevalence and potential diagnostic value in patients with other paraneoplastic neurological syndromes (PNS) is unknown. Therefore, we screened the sera of 44 PNS patients with well-characterized onconeural antibodies (anti-Hu, Yo, Ri, CV2/CRMP5, Ma1, Ma2/Ta, or amphiphysin) for anti-titin reactivity. Two patients (4.5%) were positive for anti-titin antibodies: both patients differed regarding the PNS (sensorimotor neuropathy and subacute cerebellar degeneration vs...
June 15, 2016: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/27112689/autoimmune-autonomic-disorders
#16
REVIEW
Andrew Mckeon, Eduardo E Benarroch
Autoimmune autonomic disorders occur because of an immune response directed against sympathetic, parasympathetic, and enteric ganglia, autonomic nerves, or central autonomic pathways. In general, peripheral autoimmune disorders manifest with either generalized or restricted autonomic failure, whereas central autoimmune disorders manifest primarily with autonomic hyperactivity. Some autonomic disorders are generalized, and others are limited in their anatomic extent, e.g., isolated gastrointestinal dysmotility...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27112681/autoimmune-dementia-and-encephalopathy
#17
Eoin P Flanagan, Daniel A Drubach, Bradley F Boeve
Autoimmune dementia and encephalopathies (ADE) are complex disorders that can cause immune-mediated cognitive deficits and have confusing nomenclature. Presentation varies from acute limbic encephalitis to subacute or chronic disorders of cognition mimicking neurodegenerative dementia. It may occur as a paraneoplastic phenomenon or an idiopathic autoimmune phenomenon. The presence of a personal/family history of autoimmunity, inflammatory spinal fluid, serologic evidence of autoimmunity (neural or nonorgan-specific), or mesial temporal magnetic resonance imaging abnormalities are clues to diagnosis...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/26869529/screening-for-mog-igg-and-27-other-anti-glial-and-anti-neuronal-autoantibodies-in-pattern-ii-multiple-sclerosis-and-brain-biopsy-findings-in-a-mog-igg-positive-case
#18
Sven Jarius, Imke Metz, Fatima Barbara König, Klemens Ruprecht, Markus Reindl, Friedemann Paul, Wolfgang Brück, Brigitte Wildemann
BACKGROUND: Histopathological studies have revealed four different immunopathological patterns of lesion pathology in early multiple sclerosis (MS). Pattern II MS is characterised by immunoglobulin and complement deposition in addition to T-cell and macrophage infiltration and is more likely to respond to plasma exchange therapy, suggesting a contribution of autoantibodies. OBJECTIVE: To assess the frequency of anti-myelin oligodendrocyte glycoprotein (MOG), anti-M1-aquaporin-4 (AQP4), anti-M23-AQP4, anti-N-methyl-d-aspartate-type glutamate receptors (NMDAR) and 25 other anti-neural antibodies in pattern II MS...
October 2016: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/26683964/small-cell-lung-cancer-accompanied-by-tonsillar-metastasis-and-anti-hu-antibody-associated-paraneoplastic-neuropathy-a-rare-case-report-with-long-term-survival
#19
Jianjiao Ni, Linqian Weng, Mingsheng Liu, Hua Yang, Yingyi Wang
Tonsillar metastatic small cell lung cancer (SCLC) is rare, while anti-Hu antibodies are frequently found in SCLC. A 66-year-old man was admitted to our hospital with painful dysesthesia and muscle weakness in the distal extremities for over 1 year, progressive dysphagia for over 1 month, and severe cough and dyspnea for over 1 week. He was diagnosed with SCLC accompanied by tonsillar metastasis and anti-Hu antibody-associated paraneoplastic sensory neuropathy (PSN). The patient tolerated 6 cycles of sequential chemoradiotherapy and gradually recovered...
December 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26664526/breast-cancer-revealed-by-a-paraneoplastic-cerebellar-syndrome-about-one-case-and-literature-review
#20
REVIEW
Dembélé Adama, Bambara Moussa, Macoumi Emmanuel, Ullmann Dennis
To describe a case of breast cancer manifested by cerebellar syndrome and to establish a relationship between breast cancer and Paraneoplastic syndromes through the presence of anti- yo antibodies in serum and cerebrospinal fluid of a patient. Our patient was 52 years old, Multipara with 5 children alive. She had been 3 years post-menopausal under Hormonal Replacement Therapy. Weight: 46.7 Kg; Height: 1.60 m; Body Surface Area: 1.59 m(2). Nil history of alcohol or tobacco smoking. Nil history suggestive of malignancies or autoimmune diseases...
2015: Pan African Medical Journal
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