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一名肺癌患者出现两种副肿瘤性神经综合征的罕见病例。

An Unusual Case of Two Paraneoplastic Neurological Syndromes in a Patient With Lung Cancer.

作者信息

Pia Shermila, Looi David, Stone Robert, Zhong Ning, Lui Forshing

机构信息

Neurology, University of Rochester, Rochester, USA.

Neurology, California Northstate University College of Medicine, Elk Grove, USA.

出版信息

Cureus. 2022 Dec 28;14(12):e33047. doi: 10.7759/cureus.33047. eCollection 2022 Dec.

Abstract

Paraneoplastic immune-mediated disorders have been well described in the literature. However, it is still relatively rare. The incidence has increased over the past decade due largely to the discovery of more autoantibodies. With a better understanding of the pathophysiology of different autoantibodies and clinical phenotypes, we are often able to diagnose clinically some specific paraneoplastic autoimmune neurological syndromes. We may also predict the response to treatment based on the autoantibody class. We are presenting a very unusual case of two completely different paraneoplastic syndromes with two different autoantibodies, gamma-aminobutyric acid-B (GABA) and collapsin response mediator protein 5 (CRMP5), in a patient with underlying small-cell lung cancer. We will discuss the differences in the two antibody syndromes, their significance, and their management.

摘要

副肿瘤性免疫介导性疾病在文献中已有充分描述。然而,它仍然相对罕见。在过去十年中,发病率有所上升,这主要归功于更多自身抗体的发现。随着对不同自身抗体的病理生理学和临床表型有了更深入的了解,我们常常能够在临床上诊断出一些特定的副肿瘤性自身免疫性神经综合征。我们还可以根据自身抗体类别预测治疗反应。我们在此呈现一个非常罕见的病例,一名患有小细胞肺癌的患者出现了两种完全不同的副肿瘤综合征,伴有两种不同的自身抗体,即γ-氨基丁酸-B(GABA)和塌陷反应介导蛋白5(CRMP5)。我们将讨论这两种抗体综合征的差异、它们的意义以及治疗方法。

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