[Carcinomatous autonomic neuropathy and the autoantibodies in paraneoplastic neuropathy]

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.