Neurological, serological and oncological characteri-stics of patients with paraneoplastic peripheral neuro-pathies

Abstract

Background and aims: To study the neurological, serological andoncological characteristics of patients with paraneoplastic neu-ropathies.Methods: Patients diagnosed to have peripheral neuropathy inQueen Mary Hospital and Tung Wah Hospital from 1/2001 to12/2004 were studied. All had standard workup including electro-physiological studies. Patients suspected of having paraneoplasticneuropathies were referred to an oncologist. Their sera werescreened for neuronal autoantibodies by indirect immunofluores-cence using slides containing monkey cerebellum and mouse gut(Binding Site, Birmingham, UK). Paraneoplastic neuropathy wasdiagnosed according to criteria of Graus et al. (2004).Results: 12 patients had paraneoplastic neuropathies. Their meanage at neuropathy onset was 67.8 years (range 19–86). 5 werewomen. Mean follow-up duration was 54.3 months (range 36–84).Neuropathies preceded detection of underlying malignancy in 5patients by a mean duration of 3.3 months (range 1–4.5), whichincluded acute inflammatory demyelinating polyneuropathy(AIDP) in 3, sensory neuropathy (2), autonomic neuropathy (2),multiple cranial neuropathies (2), sensorimotor axonal polyneu-ropathy (1) and chronic inflammatory demyelinating polyneuropa-thy (1). One patient had cerebellar ataxia coexisting with sensoryneuropathy. Malignancies detected included nasopharyngeal car-cinoma (3), lymphoma (2), adenocarcinoma of lung (1), breast (1),prostate (1), colon (1), oesophagus (1), prostate (1), and thymoma(1). Immunofluorescence detected Purkinje cell antibody type 1(PCA-1, anti-Yo) in a breast adenocarcinoma patient with cerebel-lar ataxia and sensory neuropathy. A novel autoantibody stainingPurkinje cell cytoplasm was detected in a nasopharyngeal carcino-ma patient with multiple cranial neuropathies.Conclusion: Diverse types of paraneoplastic neuropathies wereassociated with various solid and haematological malignancies.