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Anti-neuronal nuclear autoantibody type 2: paraneoplastic accompaniments.
- Source :
-
Annals of neurology [Ann Neurol] 2003 May; Vol. 53 (5), pp. 580-7. - Publication Year :
- 2003
-
Abstract
- We identified the IgG autoantibody ANNA-2 ("anti-Ri") in 34 patients in a 12-year period by immunofluorescence screening of sera from approximately 75000 patients with subacute neurological disorders that were suspected to be paraneoplastic. Detailed clinical information was available for 28 patients (10 men, 18 women). Cancer was diagnosed in 24 patients (86%); 21 had histologically proven carcinoma (10 lung, 9 breast, 1 cervical, 1 bladder), and 3 had an intrathoracic imaging abnormality. Cancer anteceded neurological symptoms in 4 of 28 patients. Cancer detection frequency increased with continued surveillance. Neurological disorders, in decreasing frequency, were brainstem syndrome (including opsoclonus, myoclonus, or both), cerebellar syndrome, myelopathy, peripheral neuropathy, cranial neuropathy, movement disorder, encephalopathy, Lambert-Eaton syndrome, and seizures. Four patients had laryngospasm and four had jaw opening dystonia (two with neck dystonia). Nine (32%) were wheelchair-bound 1 month after neurological symptom onset. Most improved neurologically after immunomodulatory or tumor-directed therapy. Accompanying autoantibodies, found in 73% of sera, included ANNA-1, ANNA-3, CRMP-5-IgG, P/Q-type and N-type Ca(2+) channel antibodies, and muscle-type acetylcholine receptor antibody. Some neurological accompaniments of ANNA-2 may reflect potentially pathogenic humoral or cell-mediated responses to coimmunogenic tumor antigens, for example, Lambert-Eaton syndrome (P/Q-type Ca(2+) channel antibody) and peripheral neuropathy (ANNA-1 effector T cells).
- Subjects :
- Adult
Aged
Aged, 80 and over
Antibodies, Antinuclear blood
Antibodies, Antinuclear cerebrospinal fluid
Ataxia epidemiology
Ataxia etiology
Autoantibodies blood
Autoantibodies cerebrospinal fluid
Carcinoma complications
Carcinoma therapy
Deglutition Disorders epidemiology
Deglutition Disorders etiology
Diplopia epidemiology
Diplopia etiology
Female
Fluorescent Antibody Technique, Indirect
Humans
Male
Middle Aged
Paraneoplastic Polyneuropathy complications
Paraneoplastic Polyneuropathy therapy
Prospective Studies
Receptors, Cholinergic immunology
Vertigo epidemiology
Vertigo etiology
Antibodies, Antinuclear immunology
Autoantibodies immunology
Carcinoma immunology
Immunoglobulin G immunology
Neurons immunology
Paraneoplastic Polyneuropathy immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0364-5134
- Volume :
- 53
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of neurology
- Publication Type :
- Academic Journal
- Accession number :
- 12730991
- Full Text :
- https://doi.org/10.1002/ana.10518