Anti-Hu Antibody-associated Paraneoplastic Neurological Syndrome Showing Peripheral Neuropathy and Atypical Multifocal Brain Lesions

Intern Med. 2015;54(23):3057-60. doi: 10.2169/internalmedicine.54.4867. Epub 2015 Dec 1.

Abstract

A 64-year-old Japanese woman presented with a three-month history of progressive numbness and weakness of the lower extremities. A neurological examination and nerve conduction study indicated sensorimotor polyneuropathy. Since the serum anti-Hu antibody titer was remarkably elevated, paraneoplastic neurological syndrome was highly suspected. A thoracoscopic biopsy of the hilar lymph nodes, in which (18)F-fluorodeoxyglucose uptake was obviously increased, revealed pathological findings for small-cell lung cancer (SCLC). Subsequently, the patient presented with generalized tonic-clonic seizures, and cerebral MRI showed reversible multifocal brain lesions, considered to reflect paraneoplastic encephalopathy. After two courses of chemotherapy for SCLC, the brain lesions totally disappeared.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Antinuclear
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Autoantibodies / blood
  • Brain / pathology*
  • Carcinoma, Small Cell / complications
  • Carcinoma, Small Cell / diagnosis*
  • ELAV Proteins / immunology
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis*
  • Middle Aged
  • Paraneoplastic Syndromes / complications
  • Paraneoplastic Syndromes / diagnosis*
  • Paraneoplastic Syndromes, Nervous System / complications
  • Paraneoplastic Syndromes, Nervous System / diagnosis*
  • Paraneoplastic Syndromes, Nervous System / drug therapy*
  • Peripheral Nervous System Diseases / complications
  • Peripheral Nervous System Diseases / diagnosis*

Substances

  • Antibodies, Antinuclear
  • Autoantibodies
  • ELAV Proteins