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Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies.
J Neurol Neurosurg Psychiatry. 2009 Apr; 80(4):412-6.JN

Abstract

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.

Authors+Show Affiliations

Centre de Référence Maladies Rares Syndromes Neurologiques Paranéoplasiques, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France. jerome.honnorat@chu-lyon.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18931014

Citation

Honnorat, J, et al. "Onco-neural Antibodies and Tumour Type Determine Survival and Neurological Symptoms in Paraneoplastic Neurological Syndromes With Hu or CV2/CRMP5 Antibodies." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 80, no. 4, 2009, pp. 412-6.
Honnorat J, Cartalat-Carel S, Ricard D, et al. Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies. J Neurol Neurosurg Psychiatry. 2009;80(4):412-6.
Honnorat, J., Cartalat-Carel, S., Ricard, D., Camdessanche, J. P., Carpentier, A. F., Rogemond, V., Chapuis, F., Aguera, M., Decullier, E., Duchemin, A. M., Graus, F., & Antoine, J. C. (2009). Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies. Journal of Neurology, Neurosurgery, and Psychiatry, 80(4), 412-6. https://doi.org/10.1136/jnnp.2007.138016
Honnorat J, et al. Onco-neural Antibodies and Tumour Type Determine Survival and Neurological Symptoms in Paraneoplastic Neurological Syndromes With Hu or CV2/CRMP5 Antibodies. J Neurol Neurosurg Psychiatry. 2009;80(4):412-6. PubMed PMID: 18931014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies. AU - Honnorat,J, AU - Cartalat-Carel,S, AU - Ricard,D, AU - Camdessanche,J Ph, AU - Carpentier,A F, AU - Rogemond,V, AU - Chapuis,F, AU - Aguera,M, AU - Decullier,E, AU - Duchemin,A M, AU - Graus,F, AU - Antoine,J C, Y1 - 2008/10/17/ PY - 2008/10/22/pubmed PY - 2009/4/21/medline PY - 2008/10/22/entrez SP - 412 EP - 6 JF - Journal of neurology, neurosurgery, and psychiatry JO - J. Neurol. Neurosurg. Psychiatry VL - 80 IS - 4 N2 - 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. SN - 1468-330X UR - https://www.unboundmedicine.com/medline/citation/18931014/Onco_neural_antibodies_and_tumour_type_determine_survival_and_neurological_symptoms_in_paraneoplastic_neurological_syndromes_with_Hu_or_CV2/CRMP5_antibodies_ L2 - http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=18931014 DB - PRIME DP - Unbound Medicine ER -