Kusunoki S, Kanazawa I
Department of Neurology, Faculty of Medicine, University of Tokyo.
Nihon Rinsho. 1992 Apr;50(4):834-9.
Carcinomatous autonomic neuropathy is a syndrome of autonomic dysfunction associated with malignant neoplasm. It is most often associated with small-cell lung cancer. Auto-immune mechanism is suspected to underlie this syndrome. Among the symptoms of autonomic dysfunction, intestinal pseudo-obstruction is most frequently seen. The autonomic dysfunction often precedes the discovery of the cancer. Several autoantibodies have been reported in paraneoplastic neuropathies. Anti-Hu antibody, which was originally reported in paraneoplastic sensory neuronopathy, has also been detected in some cases with autonomic failure. Anticarbohydrate antibody activity has been frequently shown in IgM M-proteins associated with peripheral neuropathies. These include anti-MAG, Po, and sulphated glucuronyl glycolipids in demyelinating neuropathy and anti-GM1 in motor dominant neuropathy or motor neuron disease. Further investigation should reveal more glycoconjugate antigens as targets of possible auto-immune attack in paraneoplastic neuropathies.
癌性自主神经病变是一种与恶性肿瘤相关的自主神经功能障碍综合征。它最常与小细胞肺癌相关。怀疑自身免疫机制是该综合征的基础。在自主神经功能障碍的症状中，肠假性梗阻最为常见。自主神经功能障碍通常在癌症被发现之前出现。在副肿瘤性神经病变中已报道了几种自身抗体。最初在副肿瘤性感觉神经元病中报道的抗Hu抗体，在一些自主神经功能衰竭的病例中也被检测到。与周围神经病变相关的IgM M蛋白中经常显示出抗碳水化合物抗体活性。这些包括脱髓鞘性神经病变中的抗MAG、Po和硫酸化葡萄糖醛酸糖脂，以及运动优势性神经病变或运动神经元病中的抗GM1。进一步的研究应揭示更多的糖结合抗原作为副肿瘤性神经病变中可能的自身免疫攻击靶点。
