Autonomic paraneoplastic neurological syndromes

Lorusso, Lorenzo; Hart, Ian; Ferrari, Daniela; Ngonga, Gaelle K.; Gasparetto, Chiara; Ricevuti, Giovanni

doi:10.1016/j.autrev.2006.10.003

Cited by 36 publications

(19 citation statements)

References 29 publications

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“…Autonomic paraneoplastic neurological syndromes (PNS) typically present as chronic GI pseudo‐obstruction or orthostatic hypotension, usually in association with other PNS rather than in isolation . Case reports highlight the importance of a thorough search for malignancy in patients with high levels of circulating paraneoplastic autoantibodies and GI dysmotility (see Table ), which can lead to earlier cancer diagnosis with improved survival .…”

Section: Classification Aetiology and Clinical Presentationsmentioning

confidence: 99%

Review article: the assessment and management of chronic severe gastrointestinal dysmotility in adults

Paine

McLaughlin

Lal

2013

Aliment Pharmacol Ther

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Section: Classification Aetiology and Clinical Presentationsmentioning

confidence: 99%

Review article: the assessment and management of chronic severe gastrointestinal dysmotility in adults

Paine

McLaughlin

Lal

2013

Aliment Pharmacol Ther

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“…Some rheumatologic disorders such as myopathies, rheumatoid arthritis, scleroderma or dermatomyositis, and some atypical vasculitides, can precede the clinical manifestations of a variety of solid and hematological tumors [12,13]. In neurological paraneoplastic syndromes, autoantibodies have been frequently detected in the sera of patients with breast and other neoplasms prior to the clinical diagnosis of cancer [14–17]. Even though these syndromes are rare, they provide clear examples of autoantibodies preceding the clinical diagnosis of cancer.…”

Section: Association Of Car and Mar With Anti-retinal Autoantibodiesmentioning

confidence: 99%

Autoantibody targets and their cancer relationship in the pathogenicity of paraneoplastic retinopathy

Adamus

2009

Autoimmunity Reviews

186

160

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Paraneoplastic retinopathies (PR), including cancer-associated retinopathy (CAR) or the closely related melanoma-associated retinopathy (MAR) occur in a small subset of patients with retinal degeneration and systemic cancer. This autoimmune syndrome is characterized by sudden, progressive loss of vision in association with circulating anti-retinal autoantibodies. The PR syndromes are heterogeneous, may produce a number of ocular symptoms, and may be associated with several different neoplasms, including lung, breast, prostate, gynecological, and colon cancer, melanoma, and hematologic malignancies. We examined the onset of retinopathy in correlation to the diagnosis of cancer and the presence of specific anti-retinal autoantibodies in PR patients. In some patients without diagnosed malignant tumors, the onset of ocular symptoms and the presence of autoantibodies preceded the diagnosis of cancer by months to years, including anti-recoverin, antitransducin-α, and anti-carbonic anhydrase II antibodies. Although anti-retinal autoantibodies may not be a good predictor of a specific neoplasm, they can be used as biomarkers for different subtypes of retinopathy. Identification of autoantibodies involved in autoimmune-mediated PR will help elucidate the mechanisms underlying the PR syndromes and develop targeted therapies for these sight-threatening disorders. KeywordsCancer-associated retinopathy; anti-retinal autoantibodies; recoverin; enolase; autoimmune retinopathy Take home message• Retinal autoantigens can be used as biomarkers for different subtypes of CAR.• Autoantibodies to retinal antigens that also recognize tumor autoantigens may be useful biomarkers for the cause and origin of paraneoplastic disease.• In some patients, the onset of ocular symptoms and the detection of anti-retinal autoantibodies may precede the diagnosis of systemic cancer.• The recognition of retinopathy as part of a paraneoplastic syndrome should prompt an immediate search for an occult neoplasm.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. • Early detection of anti-retinal autoantibodies may serve to identify those who are at risk of retinal deterioration and blindness. NIH Public Access

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“…Around 80% of patients with paraneoplastic syndrome will show involvement of other systems before the appearance of the tumor [8,9]. Since the antibodies had their target antigens expressed by both tumor and neuronal cells, the antibody will damage the function of organs and peripheral nerve.…”

Section: Discussionmentioning

confidence: 99%

Orthostatic Hypotension and Albuminocytologic Dissociation as Primary Manifestations of the Paraneoplastic Syndrome

Xing

et al. 2018

Eur Neurol

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Background: Orthostatic hypotension (OH) is the key manifestation of autonomic dysfunction with many causes. Systemic neurological causes such as paraneoplastic syndrome are usually ignored. Methods: We retrospectively analyzed clinical and examination data of 2 patients who were hospitalized, with onset symptom of OH and who were diagnosed as paraneoplastic syndrome. Results: The patients were characteristic of an initial symptom of OH, positive anti-Hu antibody and albuminocytologic dissociation in the cerebrospinal fluid. Patient 2 died and Patient 1 worsened during follow-up. Conclusions: The diagnosis of paraneoplastic syndrome is usually neglected when the onset symptoms are autonomic dysfunctions such as OH. Neurologists should improve their knowledge to diagnose accurately.

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Autonomic paraneoplastic neurological syndromes

Cited by 36 publications

References 29 publications

Review article: the assessment and management of chronic severe gastrointestinal dysmotility in adults

Review article: the assessment and management of chronic severe gastrointestinal dysmotility in adults

Autoantibody targets and their cancer relationship in the pathogenicity of paraneoplastic retinopathy

Orthostatic Hypotension and Albuminocytologic Dissociation as Primary Manifestations of the Paraneoplastic Syndrome

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