Isolated paraneoplastic optic neuropathy associated with small-cell lung cancer and anti-CV2 antibodies

Anti-Collapsing Response-Mediating Protein-5 Antibody–Positive Paraneoplastic Perioptic Neuritis without Typical Neurological Symptoms

“…One case 7 suffered bilateral deterioration in light perception, and mild enhancement and enlargement were observed only in the right optic nerve on MRI. The other two cases presented normal MRI findings, with mild visual acuity improvement in one case 12 and full recovery of visual acuity but substantial remaining visual field defects in the other case. 8 Compared with these cases, recovery of our patient involved normal visual acuity and a normal visual field.…”

“…To the best of our knowledge, only three anti-CRMP-5 antibody-positive PON cases with only optic neuropathy as a neurological symptom have been previously reported. 7,8,12 The visual prognoses of these cases and MRI findings varied. One case 7 suffered bilateral deterioration in light perception, and mild enhancement and enlargement were observed only in the right optic nerve on MRI.…”

“…6,12,[18][19][20] The visual acuity of our case improved after receiving only chemotherapy and radiotherapy. It was possible that additional immune suppression was not necessary because the amount of antibody decreased with a decrease of the tumour size.…”

“…1,[3][4][5] The various neurological symptoms are believed to be caused by an antitumour immune response 3,6 associated with an increased level of autoantibodies against collapsing response-mediating protein-5 (CRMP-5), 4,5,[7][8][9] which is expressed in the optic nerve, neurons of the central and peripheral nervous systems, oligodendrocytes, the cytoplasm of small cell lung carcinoma (SCLC) cells, or thymomas.- 5,6,[9][10][11] Only a few studies have reported anti-CRMP-5 antibody-positive PON cases that presented with optic neuropathy as the only clinical symptom. Magnetic resonance imaging (MRI) of these cases has been reported as normal, 8,12 or involving unilateral optic nerve involvement. 7 In the following case report, we describe an anti-CRMP-5 antibodypositive PON patient without neurological symptoms who presented with bilateral perioptic neuritis.…”

Mecanismos fisiopatológicos, aproximación diagnóstica e implicaciones pronósticas del síncope vasovagal neuromediano en el anciano.

“…Anti-CV2 es otro marcador recientemente identificado de carcinoma microcítico de pulmón 42,43 . Aunque este tumor es el más frecuentemente asociado a los títulos altos de este anticuerpo (59,6% de los casos con anti-CV2 positivos), también se asocia a timoma (12,8% de los casos con anti-CV2 positivos) y tumores extratorácicos como carcinoma indiferenciado, sarcoma uterino y carcinoma de células pequeñas de próstata, por orden de frecuencia descendente 44,45 .…”