Paraneoplastic Neurologic Syndrome in the PNS Euronetwork Database A European Study From 20 Centers

被引:258
作者
Giometto, Bruno [1 ]
Grisold, Wolfgang [3 ]
Vitaliani, Roberta
Graus, Francesc [4 ,5 ]
Honnorat, Jerome [6 ,7 ]
Bertolini, Guido [2 ]
机构
[1] Osped Cafoncello, Dept Neurol, Azienda Unita Locale Sociosanit Treviso 9, I-31100 Treviso, Italy
[2] Mario Negri Inst Pharmacol Res, Clin Epidemiol Lab, I-20157 Milan, Italy
[3] Ludwig Boltzmann Inst Vienna, Dept Neurooncol, Vienna, Austria
[4] Hosp Clin Barcelona, Neurol Serv, Barcelona, Spain
[5] Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain
[6] Hop Neurol, Hosp Civils Lyon, Ctr Reference Maladie Rare Syndromes Neurol Paran, Bron, France
[7] Univ Lyon 1, INSERM, F-69365 Lyon, France
关键词
CEREBELLAR DEGENERATION; ANTI-HU; NERVOUS-SYSTEM; INTRAVENOUS IMMUNOGLOBULIN; ANTINEURONAL ANTIBODIES; LIMBIC ENCEPHALITIS; ASSOCIATION; CANCER; YO; ENCEPHALOMYELITIS;
D O I
10.1001/archneurol.2009.341
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Paraneoplastic neurologic syndrome (PNS) represents the remote effects of cancer on the nervous system. Diagnostic criteria for the syndrome were published by the PNS Euronetwork and form the basis of a database to collect standardized clinical data from patients with PNS. Objectives: To analyze various types of PNS, frequent tumor and antibody associations, clinical characteristics of individual syndromes, and possible therapeutic and prognostic strategies. Design: Prospective case series and database study. Setting: Twenty European centers. Patients: Patients were recruited from January 1, 2000, to December 31, 2008. Main Outcome Measures: Based on diagnostic criteria published by the PNS Euronetwork consortium, clinical characteristics of classic PNS and several other less well-characterized syndromes associated with cancer were assessed. Results: Data from 979 patients were analyzed, representing the largest PNS investigation to date. The findings elucidate the clinical evolution of paraneoplastic cerebellar syndrome according to the onconeural antibodies present, the heterogeneity and prognosis of dysautonomic disorders, and the clinical variability of paraneoplastic limbic encephalitis. Conclusion: The study results confirm that PNS influences oncologic patient survival. Tumors are the main cause of death, but some types of PNS (such as dysautonomia) have a poorer prognosis than malignant neoplasms. Arch Neurol. 2010; 67(3): 330-335
引用
收藏
页码:330 / 335
页数:6
相关论文
共 24 条
[1]   Peripheral nervous system involvement in patients with cancer [J].
Antoine, Jean-Christophe ;
Camdessanche, Jean-Philippe .
LANCET NEUROLOGY, 2007, 6 (01) :75-86
[2]   Anti-Tr antibodies as markers of paraneoplastic cerebellar degeneration and Hodgkin's disease [J].
Bernal, F ;
Shams'ili, S ;
Rojas, I ;
Sanchez-Valle, R ;
Saiz, A ;
Dalmau, J ;
Honnorat, J ;
Smitt, PS ;
Graus, F .
NEUROLOGY, 2003, 60 (02) :230-234
[3]   ANTI-HU-ASSOCIATED PARANEOPLASTIC ENCEPHALOMYELITIS SENSORY NEURONOPATHY - A CLINICAL-STUDY OF 71 PATIENTS [J].
DALMAU, J ;
GRAUS, F ;
ROSENBLUM, MK ;
POSNER, JB .
MEDICINE, 1992, 71 (02) :59-72
[4]   Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies [J].
Dalmau, Josep ;
Gleichman, Amy J. ;
Hughes, Ethen G. ;
Rossi, Jeffrey E. ;
Peng, Xiaoyu ;
Lai, Meizan ;
Dessain, Scott K. ;
Rosenfeld, Mynna R. ;
Balice-Gordon, Rita ;
Lynch, David R. .
LANCET NEUROLOGY, 2008, 7 (12) :1091-1098
[5]   Paraneoplastic syndromes involving the nervous system [J].
Darnell, RB ;
Posner, JB .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (16) :1543-1554
[6]  
Graus F, 2004, J NEUROL NEUROSUR PS, V75, P1135, DOI 10.1136/jnnp.2003.034447
[7]   Anti-Hu-associated paraneoplastic encephalomyelitis:: analysis of 200 patients [J].
Graus, F ;
Keime-Guibert, F ;
Reñe, R ;
Benyahia, B ;
Ribalta, T ;
Ascaso, C ;
Escaramis, G ;
Delattre, JY .
BRAIN, 2001, 124 :1138-1148
[8]   Anti-Hu antibodies in patients with small-cell lung cancer: Association with complete response to therapy and improved survival [J].
Graus, F ;
Dalmau, J ;
Rene, R ;
Tora, M ;
Malats, N ;
Verschuuren, JJ ;
Cardenal, F ;
Vinolas, N ;
delMuro, JG ;
Vadell, C ;
Mason, WP ;
Rosell, R ;
Posner, JB ;
Real, FX .
JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (08) :2866-2872
[9]   Paraneoplastic limbic encephalitis: neurological symptoms, immunological findings and tumour association in 50 patients [J].
Gultekin, SH ;
Rosenfeld, MR ;
Voltz, R ;
Eichen, J ;
Posner, JB ;
Dalmau, J .
BRAIN, 2000, 123 :1481-1494
[10]   Treatment of paraneoplastic neurological syndromes with antineuronal antibodies (Anti-Hu, Anti-Yo) with a combination of immunoglobulins, cyclophosphamide, and methylprednisolone [J].
Keime-Guibert, F ;
Graus, F ;
Fleury, A ;
René, R ;
Honnorat, J ;
Broet, P ;
Delattre, JY .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2000, 68 (04) :479-482