Anti‐Hu antibody‐mediated limbic encephalitis associated with cervical cancer: A case report

Shin, Kyoungsoon; Ji, Yong

doi:10.1111/jog.13619

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…It is commonly associated with sensory neuropathy/neuronopathy, dysautonomia, intestinal pseudo-obstruction, as well as brainstem, cerebellar, and limbic/cortical encephalitis [69][70][71]. Documented non-SCLC malignancies have included neuroendocrine tumors, adenocarcinomas, squamous cell carcinomas, germinomas, and large-cell tumors, although these represent a minority [16,72,73]. Interestingly, a small series of eight children with anti-Hu/ANNA-1 antibodies described six cases of limbic encephalitis with negative malignancy workup, and another two cases of opsoclonus-myoclonus with underlying neuroblastoma [74].…”

Section: Paraneoplastic Encephalitidesmentioning

confidence: 99%

Paraneoplastic Neurological Syndromes of the Central Nervous System: Pathophysiology, Diagnosis, and Treatment

et al. 2023

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Paraneoplastic neurological syndromes (PNS) include any symptomatic and non-metastatic neurological manifestations associated with a neoplasm. PNS associated with antibodies against intracellular antigens, known as “high-risk” antibodies, show frequent association with underlying cancer. PNS associated with antibodies against neural surface antigens, known as “intermediate- or low-risk” antibodies, are less frequently associated with cancer. In this narrative review, we will focus on PNS of the central nervous system (CNS). Clinicians should have a high index of suspicion with acute/subacute encephalopathies to achieve a prompt diagnosis and treatment. PNS of the CNS exhibit a range of overlapping “high-risk” clinical syndromes, including but not limited to latent and overt rapidly progressive cerebellar syndrome, opsoclonus-myoclonus-ataxia syndrome, paraneoplastic (and limbic) encephalitis/encephalomyelitis, and stiff-person spectrum disorders. Some of these phenotypes may also arise from recent anti-cancer treatments, namely immune-checkpoint inhibitors and CAR T-cell therapies, as a consequence of boosting of the immune system against cancer cells. Here, we highlight the clinical features of PNS of the CNS, their associated tumors and antibodies, and the diagnostic and therapeutic strategies. The potential and the advance of this review consists on a broad description on how the field of PNS of the CNS is constantly expanding with newly discovered antibodies and syndromes. Standardized diagnostic criteria and disease biomarkers are fundamental to quickly recognize PNS to allow prompt treatment initiation, thus improving the long-term outcome of these conditions.

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Section: Paraneoplastic Encephalitidesmentioning

confidence: 99%

Paraneoplastic Neurological Syndromes of the Central Nervous System: Pathophysiology, Diagnosis, and Treatment

et al. 2023

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“…Anti‐Hu antibodies are most often associated with small cell lung cancers; however, they have been reported in association with ovarian and cervical malignancies 16 . The typical result of this interaction is a paraneoplastic limbic encephalitis, but it can also cause additional signs of brainstem pathology, cerebellar disorder and pure sensory neuropathy 17 …”

Section: Neurological Paraneoplastic Syndromementioning

confidence: 99%

Paraneoplastic syndrome associated with gynaecological malignancy: a review of the evidence

Brown

McKenna

Forbes

et al. 2022

The Obstetric & Gynaecologis

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Paraneoplastic syndrome (PNS) is a clinical manifestation of both benign and malignant tumours. Symptoms are not attributable to direct organ involvement of the cancer nor as a therapeutic adverse effect; instead, they are a result of hormones, cytokines or growth factors released by the tumour, or an immunological response. Paraneoplastic syndromes can affect any body system, so can cause myriad potential symptoms. These clinical manifestations often pre-date those of the underlying disease process.The incidence of PNS attributable to gynaecological tumours is increasing, resulting in considerable morbidity in those affected. There is an overall lack of awareness of PNS among clinicians; this, combined with wide-ranging signs and symptoms, creates an opportunity for diagnostic difficulty and therapeutic delay. Learning objectivesTo raise awareness among clinicians to aid earlier diagnosis and treatment of paraneoplastic syndromes.

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A paraneoplastic limbic encephalitis from an anorectal small cell neuroendocrine carcinoma: a case report

et al. 2019

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BackgroundParaneoplastic limbic encephalitis (PLE) is a rare autoimmune neurological syndrome observed in cancer patients. PLE is difficult to diagnose and presents a variable response to treatment, depending on the characteristics of the tumor and neuronal autoantibodies.Case presentationA 64-year-old, Caucasian, non-smoker man presented with a rapidly developing cognitive impairment, personality change, spatial disorientation, and short-term memory loss associated with anorexia and cervical and inguinal lymph nodes. The 18F-FDG PET scan documented intensely hypermetabolic lymph nodes, which histologically corresponded to a metastasis from a small cell neuroendocrine carcinoma. The brain MRI revealed a high T2-weighted FLAIR signal of the hippocamps, consisted with a PLE. The presence of anti-neuronal Hu antibodies confirmed the diagnosis. The patient underwent plasmapheresis, associated to a systemic chemotherapy resulting in a partial and temporary improvement of the neurological symptoms. Four cycles of intravenous immunoglobulins were also necessary. After six cures of chemotherapy, the lymph node metastases regressed. However, a new anorectal lesion was detected and was histologically confirmed as a primary small cell neuroendocrine carcinoma, which was treated with concomitant chemoradiotherapy. At the end of this treatment, the patient showed a rapid tumor progression leading to his death.ConclusionsThis case highlights the rare entity, PLE, which is difficult to diagnose and manage. In addition, this is the first published case of PLE associated with an anorectal small cell neuroendocrine carcinoma, which appeared after completion of systemic chemotherapy.

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Anti‐Hu antibody‐mediated limbic encephalitis associated with cervical cancer: A case report

Cited by 4 publications

References 8 publications

Paraneoplastic Neurological Syndromes of the Central Nervous System: Pathophysiology, Diagnosis, and Treatment

Paraneoplastic Neurological Syndromes of the Central Nervous System: Pathophysiology, Diagnosis, and Treatment

Paraneoplastic syndrome associated with gynaecological malignancy: a review of the evidence

A paraneoplastic limbic encephalitis from an anorectal small cell neuroendocrine carcinoma: a case report

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