Two cases of paraneoplastic limbic encephalitis associated with small cell lung cancer and a literature review

Abstract

In the present study, two cases of paraneoplastic limbic encephalitis (PLE) associated with small cell lung cancer were reported. Using avidin-biotin immunoperoxidase methods, purified recombinant HuD western blotting and Euroline Neuronal Antigens Profile 2 immunoglobulin G western blotting, it was found that the well-characterized anti-Hu and anti-amphiphysin onconeuronal antibodies were present in the serum/cerebrospinal fluid of the patients. With a review of the literature, it was found that patients with PLE of Chinese Han nationality had two types of clinical manifestations, simple and complex, and that the lesions could also be divided into focal and scalable lesions. Furthermore, the clinical manifestations and lesion scopes were associated with certain types of cancer and antibodies. In addition, it was found that the prognosis for patients with PLE with autoantibodies targeting membrane antigens is improved compared with that for patients with PLE with autoantibodies targeting intracellular antigens, due to an increased sensitivity to immunomodulatory treatments and anti-cancer therapy.

Various clinical features of patients with anti-Hu associated paraneoplastic neurological syndromes

“…[16] In the original study by Graus et al, [17] anti-Hu antibody was first identified in 2 patients comorbid for subacute sensory neuropathy (SSN) and SCLC. Anti-Hu has also been reported in a large number of patients with various neurological disturbances, including limbic encephalitis, [18,19] brainstem encephalitis, [19] chronic gastrointestinal pseudo-obstruction, [20] and paraneoplastic cerebellar degeneration (PCD). [21] Although anti-Hu antibodies have been observed in patients with a variety of extra thoracic cancers, it is highly specific for lung cancer, especially SCLC.…”

“…Several cases in our study revealed mild pleocytosis and elevated protein and IgG concentration in the CSF, consistent with previous reports. [18] This suggests that abnormalities in the CSF are nonspecific for PNS, and findings should be used for the purpose of excluding other neurological disorders with symptoms similar to PNS, such as intracranial infection, multiple sclerosis, and malignant meningioma. In previous studies, EEG was found to be of limited diagnostic value for PNS.…”

Small-cell Lung Cancer Presented with Paraneoplastic Limbic Encephalitis

“…Olgumuzun laboratuvar sonuçları. daha sıktır1 . PLE ile ilişkili en sık malignite KHAK olup, bunun dışında bir çok solid organ tümörü (timoma, overyal teratom, özofagus squamöz hücreli karsinomu, kolon, prostat ve testis kanseri) ve he-…”