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neurologic paraneoplastic

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https://www.readbyqxmd.com/read/28653032/paraneoplastic-antigens-as-biomarkers-for-early-diagnosis-of-ovarian-cancer
#1
REVIEW
Madhumita Chatterjee, Laura C Hurley, Michael A Tainsky
Paraneoplastic syndromes are a group of rare disorders that can be triggered by an abnormal immune response to proteins from tumors of the lung, ovary, lymphatics, or breast. Paraneoplastic clinical syndromes affect < 1% of patients with cancer; however, the frequency of subclinical levels of paraneoplastic autoantibodies in asymptomatic patients with cancer is unknown. Numerous studies have reported that ovarian cancer patients show signs of paraneoplastic neurological syndromes (PNSs) before or after their cancers are diagnosed...
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28644254/sporadic-creutzfeldt-jakob-disease-with-unilateral-symptoms-in-the-setting-of-metastatic-renal-cell-carcinoma
#2
Kyle C Rossi, Christine M Stahl, Pengfei Zhang, John W Liang, Lara V Marcuse, Fred Lublin
INTRODUCTION: Although it is not rare for magnetic resonance imaging findings in Creutzfeldt-Jakob disease to be asymmetric, unilateral clinical syndromes are uncommonly reported and may confound diagnosis. In addition, neurological paraneoplastic syndromes are not common in renal cell carcinoma, though there are cases reported, often without an offending antibody isolated. CASE REPORT: A 66-year-old man was admitted with 1 month of left-sided numbness and "loss of control" of the left arm...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28620348/the-utility-of-fdg-pet-ct-in-clinically-suspected-paraneoplastic-neurological-syndrome-a-literature-review-and-retrospective-case-series
#3
Mark P Maskery, Jonathan Hill, John R Cain, Hedley C A Emsley
Paraneoplastic neurological syndrome (PNS) describes a spectrum of rare, heterogeneous neurological conditions associated with an underlying malignancy. Diagnosis of PNS is inherently difficult, with frequent misdiagnosis and delay. The literature suggests an underlying immune-mediated pathophysiology, and patients are usually tested for the presence of onconeural antibodies. With direct tumor therapy being the most effective method of stabilizing patients, there is a strong emphasis on detecting underlying tumors...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28620136/pnma5-is-essential-to-the-progression-of-meiosis-in-mouse-oocytes-through-a-chain-of-phosphorylation
#4
Xiao-Lan Zhang, Peng Liu, Zhi-Xia Yang, Jing-Jing Zhao, Lei-Lei Gao, Bo Yuan, Li-Ya Shi, Chun-Xiang Zhou, Hai-Feng Qiao, Ya-Hong Liu, Xiao-Yan Ying, Jun-Qiang Zhang, Xiu-Feng Ling, Dong Zhang
PNMA (paraneoplastic antigen MA) family includes Pnma1-6. Although other members have been found to be involved in paraneoplastic neurological disorders, death receptor-dependent apoptosis, and tumorigenesis, Pnma5 was thought to be a female fertility factor, as indicated by one genome-wide study. But until now there have not been any further functional studies about Pnma5 in female meiosis. Our preliminary study indicated that Pnma5 might play important roles in meiosis. To further address this, Pnma5 was knocked down in in-vitro maturated (IVM) mouse oocytes, which are common models for mammalian female meiosis, by specific siRNA, and results showed that the loss of Pnma5 significantly delayed the progression of meiosis I and increased chromosome segregation errors during anaphase I...
June 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28588791/synchronous-adie-s-syndrome-and-type-1-antineuronal-nuclear-antibody-anti-hu-related-paraneoplastic-neurological-syndromes-as-predictors-of-complete-response-in-limited-stage-small-cell-lung-cancer-a-case-report
#5
Katherina Bernadette Sreter, Blazenka Barisic, Marija Barisic Kutija, Suzana Kukulj, Miroslav Samarzija
Adie's syndrome (AS) and paraneoplastic sensorimotor neuropathy with cerebellar ataxia (PSN CA) are extremely rare, rapidly progressive, autoimmune diseases associated with the development of antibodies against neuronal-specific Hu proteins that are abnormally expressed in small-cell lung cancer (SCLC). We herein present the unique case of a 55-year-old obese woman, previous heavy smoker, who, during treatment with standard cisplatin-etoposide chemotherapy for limited-stage SCLC, developed simultaneous AS and worsening symptoms consistent with PSN CA that led to significant neurological disability and severe axonal electrophysiological pattern on nerve conduction studies...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28570324/neurologic-complications-of-lymphoma-leukemia-and-paraproteinemias
#6
Michelle L Mauermann
PURPOSE OF REVIEW: This article reviews the spectrum of neurologic complications associated with lymphoma, leukemia, and paraproteinemic disorders. While leptomeningeal metastasis is the most common complication of lymphoma and leukemia and peripheral neuropathy is the most common complication of paraproteinemic disorders, clinicians need to be familiar with the diverse neurologic complications of these disorders. RECENT FINDINGS: Lymphomatous nervous system involvement can be difficult to diagnose, especially when it is the presenting symptom...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28570322/autoimmune-neurology-of-the-central-nervous-system
#7
W Oliver Tobin, Sean J Pittock
PURPOSE OF REVIEW: This article reviews the rapidly evolving spectrum of autoimmune neurologic disorders with a focus on those that involve the central nervous system, providing an understanding of how to approach the diagnostic workup of patients presenting with central nervous system symptoms or signs that could be immune mediated, either paraneoplastic or idiopathic, to guide therapeutic decision making. RECENT FINDINGS: The past decade has seen a dramatic increase in the discovery of novel neural antibodies and their targets...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28566596/paraneoplastic-hypocalcemia-developed-in-gastric-cancer-accompanied-by-osteoblastic-metastasis
#8
Jun Okazaki, Naoki Muguruma, Shinji Kitamura, Tetsuo Kimura, Koichi Okamoto, Hiroshi Miyamoto, Kazuhiro Kishi, Yoshimi Bando, Takeshi Kondo, Itsuro Endo, Masahiro Abe, Tetsuji Takayama
Paraneoplastic syndromes are generally defined as clinical disorders associated with malignant diseases, and hypocalcemia associated with cancer is a rare condition. A woman in her 60s was referred to our hospital for the further examination of massive ascites due to carcinoma of unknown primary origin. She complained of numbness around her lips, and marked hypocalcemia of 5.0 mg/dL was noted. After two courses of chemotherapy, computed tomography showed a decrease in the ascites, and her serum calcium level increased...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28559410/case-report-encephalitis-with-brainstem-involvement-following-checkpoint-inhibitor-therapy-in-metastatic-melanoma
#9
Simon Bossart, Selina Thurneysen, Elisabeth Rushing, Karl Frontzek, Henning Leske, Daniela Mihic-Probst, Hannes W Nagel, Johanna Mangana, Simone M Goldinger, Reinhard Dummer
Checkpoint inhibitors are increasingly being used in the treatment of malignant melanoma and other cancers. With the use of such therapies, autoimmune-mediated adverse events in the central and peripheral nervous system are likely to occur more frequently. We report a unique case of brainstem encephalitis with a sudden lethal outcome following ipilimumab and pembrolizumab therapy in a patient with malignant melanoma. The autopsy showed a diffuse nodular activation of microglia in the whole encephalon with prominent intraparenchymal and perivascular lymphocytic infiltration of the brainstem...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28554330/rho-associated-protein-kinase-2-rock2-a-new-target-of-autoimmunity-in-paraneoplastic-encephalitis
#10
Stoyan Popkirov, Ilya Ayzenberg, Stefanie Hahn, Jan Bauer, Yvonne Denno, Nicole Rieckhoff, Christiane Radzimski, Volkmar H Hans, Sebastian Berg, Florian Roghmann, Joachim Noldus, Christian G Bien, Sabine Skodda, Jörg Wellmer, Winfried Stöcker, Christos Krogias, Ralf Gold, Uwe Schlegel, Christian Probst, Lars Komorowski, Ramona Miske, Ingo Kleiter
Onconeural antibodies are associated with cancer and paraneoplastic encephalitis. While their pathogenic role is still largely unknown, their high diagnostic value is undisputed. In this study we describe the discovery of a novel target of autoimmunity in an index case of paraneoplastic encephalitis associated with urogenital cancer.A 75-year-old man with a history of invasive bladder carcinoma 6 years ago with multiple recurrences and a newly discovered renal cell carcinoma presented with seizures and progressive cognitive decline followed by super-refractory status epilepticus...
May 29, 2017: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/28551401/imaging-workup-of-suspected-classical-paraneoplastic-neurological-syndromes-a-systematic-review-and-retrospective-analysis-of-18-f-fdg-pet-ct
#11
Benedikt Sundermann, Jens-Burchard Schröder, Tobias Warnecke, Walter Heindel, Michael Schäfers, Matthias Weckesser, Boris Buerke
RATIONALE AND OBJECTIVES: This study aimed to assess the clinical efficacy of positron emission tomography (PET) or combined PET-computed tomography (CT) with (18)F-fluorodeoxyglucose (FDG) for whole-body cancer screening in patients with suspected paraneoplastic neurological syndromes (PNS). The following main research questions were addressed: What is the percentage of positive findings to be expected in whole-body FDG-PET-CT in adult patients with PNS? How many false positives can be expected as assessed by clinical and histopathological workup? Are there patients who present with a tumor despite initially negative findings? MATERIALS AND METHODS: This is a systematic review of the literature and retrospective analysis of FDG-PET-CT and clinical follow-up data from 45 consecutive patients (age: 56...
May 24, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28550611/-18-f-fluorodeoxyglucose-positron-emission-tomography-in-the-diagnosis-of-malignancy-in-patients-with-paraneoplastic-neurological-syndrome-a-systematic-review-and-meta-analysis
#12
REVIEW
Ana María García Vicente, Roberto C Delgado-Bolton, Mariano Amo-Salas, Jesús López-Fidalgo, Ana Paula Caresia Aróztegui, José Ramón García Garzón, Javier Orcajo Rincón, María José García Velloso, María de Arcocha Torres, Soledad Alvárez Ruíz
PURPOSE: The detection of occult cancer in patients suspected of having a paraneoplastic neurological syndrome (PNS) poses a diagnostic challenge. The aim of our study was to perform a systematic review and meta-analysis to assess the diagnostic performance of FDG PET for the detection of occult malignant disease responsible for PNS. METHODS: A systematic review of the literature (MEDLINE, EMBASE, Cochrane, and DARE) was undertaken to identify studies published in any language...
May 27, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28549713/childhood-opsoclonus-myoclonus-syndrome-a-case-series-from-tunisia
#13
Nedia Ben Achour, Saloua Mrabet, Ibtihel Rebai, Ines Abid, Hanene Benrhouma, Hedia Klaa, Aida Rouissi, Ichraf Kraoua, Ilhem Ben Youssef Turki
INTRODUCTION: Opsoclonus myoclonus syndrome (OMS) is a rare immune-mediated disorder characterized by opsoclonus, myoclonus, ataxia and behavioral changes. The aim of our study was to investigate the epidemiology, clinical features, etiological aspects and outcome of OMS in Tunisian children. METHODS: We conducted a retrospective study over 11years (2005-2016) including all patients aged under 18years who were managed for newly diagnosed OMS in a tertiary care research centre for children with neurological symptoms...
May 23, 2017: Brain & Development
https://www.readbyqxmd.com/read/28546233/a-case-of-confusion-paraneoplastic-encephalomyelitis-in-an-elderly-patient-suspected-of-having-urinary-tract-infection-associated-delirium
#14
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/28515556/subacute-noninfective-inflammatory-encephalopathy-our-experience-and-diagnostic-problems
#15
Sadanandavalli Retnaswami Chandra, Lakshminarayanapuram Gopal Viswanathan, Dodmalur Malikarjuna Sindhu, Anupama Ramakanth Pai
INTRODUCTION: Immune dysregulation associated encephalopathies present with significant psychiatric manifestations and only a few soft neurological and general systemic features. They are generally resistant to treatment with psychiatric medications. Generalized orthostatic myoclonus and faciobrachial dystonic seizures are mistaken as Creutzfeldt-Jakob disease and subacute sclerosing panencephalitis. PATIENTS AND METHODS: Forty-two patients seen during 2010-2015 and diagnosed as noninfective encephalopathy were analyzed...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28511811/autoimmune-voltage-gated-potassium-channelopathy-presenting-with-catecholamine-excess
#16
K Amy Stepp, Christin Folker, Marie Tanzer, Jennifer Hayman, Thomas Reynolds, Leah Mallory
BACKGROUND: Autoimmune voltage-gated potassium channelopathies have been associated with a range of neurological presenting symptoms, including central, peripheral, and autonomic dysfunction. PATIENT DESCRIPTION: We describe a 12-year-old boy who presented with nine months of pain, anxiety, and 30-pound weight loss. He was admitted for failure to thrive, then noted to be persistently hypertensive and tachycardic. Plasma metanephrines and urine metanephrines and catecholamines were elevated...
July 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28481801/fdg-avid-keloid-on-pet-ct-imaging
#17
Zu-Gui Li
Keloid is a benign fibroproliferative growths resulting from an overexuberant healing response. A 51-year-old man with a 20-year history of keloid formation presented with a 1-year history of unexplained progressive weakness of both lower limbs. He was clinically suspected of having paraneoplastic neurologic syndrome. FDG PET/CT was performed to exclude underlying malignancy. FDG PET/CT revealed a giant FDG-avid keloid in the anterior chest wall without any other abnormal FDG uptake in the body. We emphasize that a benign FDG-avid keloid should be considered in the differential diagnosis of FDG-avid cutaneous lesions on PET/CT...
May 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28458906/delayed-dyskinesia-and-prolonged-psychosis-in-a-patient-presenting-with-profound-hyponatraemia
#18
Victoria John, Philip Evans, Atul Kalhan
SUMMARY: A 65-year-old woman was admitted to the emergency unit with a 48 h history of generalised weakness and confusion. On examination, she had mild slurring of speech although there was no other focal neurological deficit. She had profound hyponatraemia (serum sodium level of 100 mmol/L) on admission with the rest of her metabolic parameters being within normal range. Subsequent investigations confirmed the diagnosis of small-cell lung cancer with paraneoplastic syndrome of inappropriate antidiuresis (SIAD)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28432174/postintervention-acute-opsoclonus-myoclonus-syndrome
#19
Annelise Aquilina, Nicola Dingli, Josanne Aquilina
Opsoclonus myoclonus syndrome (OMS) is a rare, neurological condition affecting 1 in 10 000 000 people annually. Opsoclonus, defined as involuntary rapid, multivectorial oscillations of the eyes, together with ataxia and myoclonus are usually present. OMS may be paraneoplastic: often associated with occult neuroblastoma in childhood and with breast carcinoma or small cell lung carcinoma in adults. Other aetiologies include viral or toxic agents. The pathogenesis is thought to be immune mediated. A 37-year-old woman with previous inflammatory cranial mononeuropathies was admitted for elective dilatation and curettage (D&C)...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28417344/biotherapy-in-inflammatory-diseases-of-the-cns-current-knowledge-and-applications
#20
REVIEW
Nicolas Collongues, Laure Michel, Jérôme de Seze
Biotherapy represents an innovative therapeutic approach that includes immunotherapy (vaccines, apheresis, and antibodies); gene therapy; and stem cell transplants. Their development helps to cross the bridge from bench to bedside and brings new hope of a cure for severe diseases in different fields of medicine. In neurology, a growing range of applications is being developed for these medications. Valuable results are now available in the field of autoimmunity, neuro-oncology, paraneoplastic manifestations, and neurodegenerative disorders...
May 2017: Current Treatment Options in Neurology
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