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

Abstract

To describe and analyze the clinical features and prognosis of patients with anti-Hu associated paraneoplastic neurological syndromes (PNS).The symptoms, MRI findings, cerebrospinal fluid (CSF) changes, electroencephalogram (EEG) characteristics and prognoses of 9 well-diagnosed anti-Hu associated PNS patients were analyzed.The study enrolled 6 female and 3 male patients. Three patients presented with vertigo and 6 patients exhibited a depressed mood, numbness of the lower limbs, generalized pains, seizures, mental disturbances, and a temporary unilateral hand tremor on initial presentation. Three patients presented with MRI abnormalities localized in the mesial temporal lobe and the thalamus. Abnormal interictal EEG readings were observed in all 5 patients who underwent EEG study. Four patients were found lung cancer (3 during hospitalization, 1 during follow-up). Seven patients were treated with immunotherapy and improved in symptoms. Three patients died during follow-up (2 with lung cancer).The clinical manifestation of anti-Hu associated PNS is diverse and multifocal. EEG may be more sensitive than MRI for early diagnosis of PNS. Long-term follow-up for patients with CT-negative anti-Hu associated PNS is necessary.

Paraneoplastic Neurological Syndromes: Study of Prevalence in a Province of the Lombardy Region, Italy

“…The little epidemiological data available in the literature [ 11 ] mainly concern oncology and “secondary care”, indicating a frequency of about 0.01–8% in oncology patients and a high incidence of PNSs associated with SCLC, gynecological tumors and blood disorders [ 9 , 21 ]. Research on these diseases is therefore very important, because, if detected early, PNSs can be treated in cancer patients, increasing life expectancy and reducing medical costs [ 31 , 32 ].…”

A Rare Case of Sensory Neuropathy Associated with Transitional Cell Carcinoma of the Bladder

“…Amongst PNS, sensory neuropathy is the most common manifestation, accounting for approximately 50% of cases [2]. Sensory neuronopathy or ganglionopathy is a unique neurological syndrome associated with anti-Hu PNS, but an asymmetric presentation and involvement of the face and body differentiate it from more prevalent sensory neuropathy [3, 11, 12]. All patients with PNS should have age-appropriate cancer screening.…”

Update in autoimmune and paraneoplastic myelopathies: Newly described antigen targets and antibody testing

“…ANNA-1, or anti-Hu, is a well-characterized PNS, associated with SCLC in 74–94% of cases ( 32 ). While SCLC is most common, a number of other cancers have been associated including breast, prostate, gastrointestinal, ovarian and bladder cancer ( 32 , 33 ).…”

“…ANNA-1, or anti-Hu, is a well-characterized PNS, associated with SCLC in 74–94% of cases ( 32 ). While SCLC is most common, a number of other cancers have been associated including breast, prostate, gastrointestinal, ovarian and bladder cancer ( 32 , 33 ). Anti-Hu antibodies target an intracellular antigen and are therefore likely a marker of a broader cytotoxic T cell-mediated immune response as opposed to directly pathogenic.…”