Malignant Thymoma With Dysautonomia and Disordered Neuromuscular Transmission

Tabbaa, Mutaz A.; Leshner, Robert T.; Campbell, W. W.

doi:10.1001/archneur.1986.00520090079023

Cited by 34 publications

(14 citation statements)

References 16 publications

(1 reference statement)

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“…These myopathies or neuropathies can be either degenerative or inflammatory. Over recent years, observations have suggested that some cases of gastro-intestinal dysmotility are immune-mediated, based in part on the associations of CIPO with small-cell lung cancer and thymoma [7, 8, 14, 15], two tumours which frequently stimulate the immune system and result in paraneoplastic neurological disorders. In these cases, the antibodies detected in routine practice are often directed against intracellular antigens, such as Hu (ANNA-1), and are probably not pathogenic since there are few examples of a response to treatments that lower the antibody levels [16, 17].…”

Section: Discussionmentioning

confidence: 99%

Thymoma-Associated Neuromyotonia with Antibodies against Voltage-Gated Potassium Channels Presenting as Chronic Intestinal Pseudo-Obstruction

Viallard¹,

Vincent

Moreau

et al. 2005

Eur Neurol

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Chronic intestinal pseudo-obstruction can occur as a paraneoplastic disorder, and several cases have been reported in association with thymoma or small-cell lung cancer. Autoantibodies against voltage-gated potassium channels (VGKCs) are found in acquiredneuromyotonia (Isaac’s syndrome), and have been reported in one case of slow transit constipation without apparent neurological disease. We describe a patient with VGKC antibodies, acquired neuromyotonia and thymoma, who first presented with a severe slow-transit constipation and in whom the gastrointestinal symptoms responded well to plasmapheresis. We suggest that VGKC antibodies might be helpful in patients with possible paraneoplastic chronic intestinal pseudo-obstruction, and a positive result should stimulate the search for a thymoma or other tumour and raise the possibility of immunotherapy.

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Section: Discussionmentioning

confidence: 99%

Thymoma-Associated Neuromyotonia with Antibodies against Voltage-Gated Potassium Channels Presenting as Chronic Intestinal Pseudo-Obstruction

Viallard¹,

Vincent

Moreau

et al. 2005

Eur Neurol

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“…This hypothesis raises the suggestion of involvement of the cholinergic nervous systems and its pathways by well-known (e.g. neuronal nAChR Abs) [9,17,19,23,24,55] and others not well-known immune mediated processes (e.g. tumor immunology or non-specific autoimmunity or paraneoplastic manifestations)] [56] as causes of central nervous system manifestations with MG.…”

Section: The Possible Mechanisms Of Sleep Related Conditions In Patiementioning

confidence: 99%

“…Several central (e.g. brain ACh deficiency) [9,17,19,23,24] and peripheral [25,26] (e.g. respiratory muscle weakness, use of acetylcholine esterase inhibitors (AChE-Is) and weight gain from limited physical activity) mechanisms have been suggested for the association between MG and nervous system manifestations and sleep related conditions.…”

Section: Introductionmentioning

confidence: 99%

Sleep Related Conditions with Myasthenia Gravis: Evidence, Causes and Implications

Hamed¹

2016

SJPH

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Myasthenia gravis (MG) is an autoimmune disease caused mainly by antibodies against skeletal muscle nicotinic acetylcholine receptors (nAChRs) at the postsynaptic membrane resulting in depletion of acetylcholine at the neuromuscular junction (NMJ). Muscle fatigue is the cardinal symptom of MG. Respiratory muscle weakness and breathing problems are manifestations of MG even in mild stages of the disease resulting in significant morbidity and mortality. Also sleep related conditions are among the manifestations of MG which include sleep disordered breathing (SDB) [i.e. central (CSA) and obstructive (OSA) sleep apneas, hypoventilation or hypoxemic syndromes], reduced sleep efficiency and quality, increased number of nocturnal awakenings, excessive daytime sleepiness, reduced rapid eye movement sleep and altered sleep perception and dreaming. On the other hand, sleep abnormalities may result in lack of concentration, cognitive impairments and mood disturbances as depression and anxiety. Central and peripheral mechanisms have been suggested for the association between MG and central nervous system manifestations and sleep abnormalities. Neurologists and sleep medicine professionals should be aware of the associations between OSA/CSA, hypoventilation and other sleep related conditions with MG and consider systematic investigations including polysomnography and ventilatory support. This will reduce morbidity and mortality and improve quality of lives of patients with MG.

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“…Most cases of chronic intestinal pseudoobstruction are due to primary defects in the contractile apparatus (nerves, interstitial cells of Cajal, smooth muscle cells) of the gut or secondary to an infiltrating disease such as amyloidosis or scleroderma [37][38][39]. Paraneoplastic intestinal pseudoobstruction is most often reported in cases with small cell lung cancer and thymoma and is usually associated with the presence of circulating ANNA-1 antibodies [40][41][42][43][44]. Though most often seen in the setting of either small cell lung cancer or thymoma, there have been several case reports of patients with pseudo-obstruction with other primary cancers.…”

Section: Paraneoplastic Chronic Intestinal Pseudoobstructionmentioning

confidence: 99%

Enteric Autoantibodies and Gut Motility Disorders

Kashyap

Farrugia

2008

Gastroenterology Clinics of North America

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There is increasing evidence that a subset of gastrointestinal motility disorders is associated with the presence of circulating antibodies. These antibodies are directed against various molecular targets, the best known being anti-neuronal nuclear antibody (ANNA-1, aka anti-Hu) associated with paraneoplastic motility disorders. There is also evidence that the presence of distinct auto-antibody profiles is associated with non-paraneoplastic motility disorders. This review will focus on the types of antibodies associated with gastrointestinal motility disorders and the significance of these antibodies. The review will also suggest algorithms for the work up and treatment of patients with circulating antibodies associated with gastrointestinal motility disorders

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Malignant Thymoma With Dysautonomia and Disordered Neuromuscular Transmission

Cited by 34 publications

References 16 publications

Thymoma-Associated Neuromyotonia with Antibodies against Voltage-Gated Potassium Channels Presenting as Chronic Intestinal Pseudo-Obstruction

Thymoma-Associated Neuromyotonia with Antibodies against Voltage-Gated Potassium Channels Presenting as Chronic Intestinal Pseudo-Obstruction

Sleep Related Conditions with Myasthenia Gravis: Evidence, Causes and Implications

Enteric Autoantibodies and Gut Motility Disorders

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