| Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies. | |
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MedLine Citation:
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PMID: 18931014 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Anti-Hu antibodies (Hu-Ab) and anti-CV2/CRMP5 antibodies (CV2/CRMP5-Ab) have been identified in association with paraneoplastic neurological disorders. However, it is not clear whether these antibodies are associated with specific neurological symptoms or are only markers of anti-cancer immune reaction. METHODS: To address this question, 37 patients with CV2/CRMP5-Ab and 324 patients with Hu-Ab were compared. RESULTS: Whereas the age and sex ratio were the same between the two groups, the distribution of neurological symptoms was not. Patients with CV2/CRMP5-Ab presented more frequently cerebellar ataxia, chorea, uveo/retinal symptoms and myasthenic syndrome (Lambert-Eaton myasthenic syndrome LEMS or myasthenia gravis). They also had a better Rankin score. In contrast, dysautonomia, brainstem encephalitis and peripheral neuropathy were more frequent in patients with Hu-Ab. Limbic encephalitis occurred similarly in both groups. Small-cell lung cancer was the most frequently associated tumour in both groups of patients, while malignant thymoma was observed only in patients with CV2/CRMP5-Ab. In particular, patients with CV2/CRMP5-Ab and thymoma developed myasthenic syndrome more frequently, while patients with SCLC developed neuropathies more frequently. Chorea and myasthenic syndrome were only seen in patients with CV2/CRMP5-Ab. The median survival time was significantly longer in patients with CV2/CRMP5-Ab, and this effect was not dependent on the type of tumour. Interpretation: The data demonstrate that in patients with paraneoplastic neurological syndromes, the neurological symptoms and survival vary with both the type of associated onco-neural antibody and the type of tumour. |
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Authors:
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J Honnorat; S Cartalat-Carel; D Ricard; J Ph Camdessanche; A F Carpentier; V Rogemond; F Chapuis; M Aguera; E Decullier; A M Duchemin; F Graus; J C Antoine |
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Publication Detail:
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Type: Journal Article Date: 2008-10-17 |
Journal Detail:
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Title: Journal of neurology, neurosurgery, and psychiatry Volume: 80 ISSN: 1468-330X ISO Abbreviation: J. Neurol. Neurosurg. Psychiatr. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-17 Completed Date: 2009-04-20 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 2985191R Medline TA: J Neurol Neurosurg Psychiatry Country: England |
Other Details:
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Languages: eng Pagination: 412-6 Citation Subset: IM |
Affiliation:
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Centre de Référence Maladies Rares Syndromes Neurologiques Paranéoplasiques, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France. jerome.honnorat@chu-lyon.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age of Onset Aged Antibodies, Neoplasm / immunology Brain Neoplasms / epidemiology, immunology*, pathology* Female Hu Paraneoplastic Encephalomyelitis Antigens / immunology* Humans Male Middle Aged Nerve Tissue Proteins / immunology* Nervous System Diseases / etiology, physiopathology Paraneoplastic Syndromes, Nervous System / epidemiology, immunology*, pathology* Prognosis Survival Analysis Thymoma / pathology |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Neoplasm; 0/DPYSL5 protein, human; 0/Hu Paraneoplastic Encephalomyelitis Antigens; 0/Nerve Tissue Proteins |
| Comments/Corrections | |
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