Decoding Multiple Antibody Positivity: Lessons from Paraneoplastic Sensory Ataxia.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
Annals of Indian Academy of Neurology Pub Date : 2024-09-01 Epub Date: 2024-08-21 DOI:10.4103/aian.aian_307_24
S Sidharth, Ayush Agarwal, Divyani Garg, Anita Mahadevan, Shamim A Shamim, Pranjal Gupta, Divya M Radhakrishnan, Awadh K Pandit, Achal K Srivastava
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引用次数: 0

Abstract

Paraneoplastic neurologic syndromes are cancer-associated, immune-mediated neurologic manifestations that may involve any part of the nervous system. They usually present with characteristic neurologic features and should be considered in high-risk phenotypes such as limbic encephalitis, encephalomyelitis, rapidly progressive cerebellar syndrome, opsoclonus-myoclonus, sensory neuronopathy, enteric neuropathy, and Lambert-Eaton myasthenic syndrome. The diagnosis is made by antibody positivity in the serum or cerebrospinal fluid, in the presence of an appropriate clinical phenotype. Findings on antibody testing by immunoblot should always be verified by immunofluorescence. We report a rare case of sensory neuronopathy with triple paraneoplastic antibody positivity (anti-Hu, anti-collapsing response-mediator protein 5, and anti-amphiphysin) on immunoblot but only anti-Hu positivity on immunofluorescence. The presence of lower facial dyskinesias should raise the possibility of an immune-mediated neurologic syndrome in the appropriate clinical context.

解码多重抗体阳性:副肿瘤性感觉共济失调的启示
摘要:副肿瘤性神经综合征是与癌症相关的、免疫介导的神经系统表现,可累及神经系统的任何部位。副肿瘤性神经系统综合征通常具有特征性的神经系统特征,在出现肢端脑炎、脑脊髓炎、快速进展性小脑综合征、肌阵挛、感觉神经病、肠神经病和兰伯特-伊顿肌萎缩综合征等高危表型时应加以考虑。诊断的依据是血清或脑脊液中的抗体阳性,并伴有相应的临床表型。免疫印迹抗体检测结果应始终通过免疫荧光进行验证。我们报告了一例罕见的感觉神经病病例,该病例免疫印迹呈三重副瘤抗体阳性(抗-Hu、抗凝集反应介导蛋白 5 和抗蚜虫蛋白),但免疫荧光仅呈抗-Hu 阳性。在适当的临床背景下,下面部运动障碍的出现应引起免疫介导的神经系统综合征的可能性。
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来源期刊
Annals of Indian Academy of Neurology
Annals of Indian Academy of Neurology Nervous System Diseases-
CiteScore
2.20
自引率
11.80%
发文量
293
审稿时长
29 weeks
期刊介绍: The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.
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