Steroid-dependent anti-Hu negative paraneoplastic encephalomyelitis and small cell lung carcinoma

A, Arjona; Castellanos, Fernando Raga; Graus, Francesc; Sanchez, Phillip J.; Escamilla, Carlos; Pascual, Ma Luz Cilleruelo

doi:10.1007/s004150050212

Cited by 5 publications

(1 citation statement)

References 12 publications

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“…In the absence of large clinical trials, most therapeutic alternatives in patients with CNA‐antibodies derive from observational clinical studies and case reports . The usefulness of corticoids has been suggested in patients with anti‐Hu , anti‐Yo antibodies or in patients with PNS and without antibodies . Therapeutic effects of intravenous immunoglobulins (IVIg) appear to be limited, but in a very small proportion of patients with definite PNS (mainly with anti‐Hu or anti‐Yo antibodies) a favourable response has been described after IVIg therapy .…”

Section: Main Treatment Studies In Group 1 Antibodies: Antibodies Witmentioning

confidence: 99%

Early-onset immunotherapy by intravenous immunoglobulin and corticosteroids in well characterized onconeural-antibody-positive paraneoplastic neurological syndrome

Honnorat

2014

Clin Exp Immunol

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Section: Main Treatment Studies In Group 1 Antibodies: Antibodies Witmentioning

confidence: 99%

Early-onset immunotherapy by intravenous immunoglobulin and corticosteroids in well characterized onconeural-antibody-positive paraneoplastic neurological syndrome

Honnorat

2014

Clin Exp Immunol

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Paraneoplastic Neurological Syndromes: General Treatment Overview

Viaccoz

Honnorat

2013

Curr Treat Options Neurol

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Major recent discoveries have bringing out a revised definition of paraneoplastic neurological syndromes (PNS), bringing out the concept of antibody-mediated neurological disorders, triggered or not by cancer. Classification of these diseases is not based anymore on the clinical pattern or an underlying tumor, but on the location of the targeted antigens. Indeed, evolution, response to treatment, and pathophysiology are radically different according to the associated antibodies. In some patients with newly described antibodies targeting cell-surface antigens, humoral immunity seems to play a direct role and a dramatic improvement is observed with immunomodulator treatments. In these patients, an associated tumor is less frequent. Conversely, patients with antibodies directed against intracellular targets are, in most cases, characterized by a high degree of irreversible neuronal death mediated by cytotoxic T-cells and do not improve after immunomodulator treatments. In these patients, an associated tumor is highly frequent and must be cured as soon as possible. A third group of patients can be identified with anti-GAD65 and anti-Amphiphysin antibodies. In patients with these antibodies, the efficiency of immunomodulator treatments is less clear as well as the type of immune response that could be a mix between humoral and cellular. In this last group, the antigen is intracellular, but patients may improve with immunomodulator treatments and associated tumors are rare. Thus, identification of associated antibodies should be prompt and the treatment guided according the identified antibody. Mainstream of treatment include the quest of a tumor and its cure. Immunotherapy must be promptly initiated, targeting humoral, or cellular immune response, or both, according to the associated antibodies. Furthermore, in some situations such as Lambert-Eaton Myasthenic Syndromes and Stiff-Person Syndromes, symptomatic drugs can be useful to control the symptoms.

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Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature

et al. 2017

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Steroid-dependent anti-Hu negative paraneoplastic encephalomyelitis and small cell lung carcinoma

Cited by 5 publications

References 12 publications

Early-onset immunotherapy by intravenous immunoglobulin and corticosteroids in well characterized onconeural-antibody-positive paraneoplastic neurological syndrome

Early-onset immunotherapy by intravenous immunoglobulin and corticosteroids in well characterized onconeural-antibody-positive paraneoplastic neurological syndrome

Paraneoplastic Neurological Syndromes: General Treatment Overview

Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature

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