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[Paraneoplastic neuropathy with positive anti-Hu]
I Casas Parera1, D Fischman, L Paz
1Servicio de Neurologia, Instituo de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Medicina
|August 26, 1998
Summary
This case report details a 72-year-old woman with sensory neuropathy and anti-Hu antibodies, ultimately diagnosed with metastatic small cell carcinoma. Despite widespread metastasis, she maintained independence, indicating an indolent clinical course.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Anti-Hu antibodies are associated with paraneoplastic neurological syndromes.
- Sensory neuropathy can be an early manifestation of underlying malignancy.
Observation:
- A 72-year-old woman presented with a year of progressive sensory neuropathy, including painful numbness, dysesthesias, and gait disturbances.
- Neurologic examination revealed Argyll-Robertson pupils, absent reflexes, sensory deficits, and pseudoathetotic movements.
- Elevated ESR and IgG, mild demyelinating neuropathy, and positive anti-Hu antibodies were noted.
Findings:
- CT scans identified metastatic small cell carcinoma in the lungs, liver, adrenal gland, and peritoneum.
- The patient exhibited an indolent clinical course, remaining independent despite widespread metastatic disease.
Implications:
- This case highlights the importance of investigating sensory neuropathy for occult malignancies, particularly small cell carcinoma.
- The presence of anti-Hu antibodies can be a crucial diagnostic marker for paraneoplastic syndromes.
- An indolent course in metastatic small cell carcinoma, even with paraneoplastic neurological symptoms, is possible.