Paraneoplastic gastrointestinal motor dysfunction: clinical and laboratory characteristics

Area of Science:

• Gastroenterology
• Neurology
• Oncology

Background:

• Paraneoplastic syndromes occur when cancer triggers an immune response affecting distant organs.
• Gastrointestinal (GI) motor dysfunction can be a manifestation of paraneoplastic syndromes.
• Early diagnosis is crucial for managing these complex conditions.

Purpose of the Study:

• To characterize the clinical, manometric, and serological features of paraneoplastic GI motor dysfunction.
• To evaluate the diagnostic utility of various tests in identifying underlying malignancies.

Main Methods:

• Retrospective analysis of 12 patients with malignant tumors and GI motor dysfunction.
• Clinical assessment, esophageal manometry, gastric emptying scintigraphy, and autoimmune serology.

Main Results:

• Small cell lung carcinoma (SCLC) was the most common malignancy (9/12).
• GI symptoms preceded tumor diagnosis in all SCLC cases.
• Paraneoplastic autoantibodies, including anti-Hu (ANNA-1), anti-Yo (PCA-1), and N-type calcium channel antibodies, were frequently detected.
• Delayed gastric emptying and esophageal dysmotility were common.
• Abnormal autonomic reflex tests were observed.

Conclusions:

• Paraneoplastic GI motor dysfunction necessitates a high clinical suspicion.
• Serological tests for autoantibodies, gastric emptying studies, and manometry are valuable screening tools.
• Positive autoantibody results (ANNA-1, PCA-1, N-type calcium channel) warrant further investigation for malignancy, even with negative imaging.