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Departments of Neurology (Drs. Anderson and Posner) and Pathology (Neuropathology) (Dr. Rosenblum), Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY; Hospital Clinic i Provincial de Barcelona (Dr. Graus), Spain; Veterans Administration Medical Center and Vanderbilt University (Dr. Wiley), Nashville, TN.
An antineuronal autoantibody has been identified in serum from 14 patients, 8 women and 6 men, with small-cell lung carcinoma (SCLC) and a neurologic disorder. Neurologic symptoms began prior to diagnosis of the SCLC in 12 patients. The dominant neurologic disorder was a subacute sensory neuronopathy (SSN) in eight patients, SSN plus lower motor neuron weakness (2 patients), SSN plus autonomic neuropathy (1 patient), cerebellar ataxia (1 patient), myelopathy (1 patient), and multifocal nervous system disease (encephalomyelitis) in one patient. The presence of the same autoantibody in patients with SSN, encephalomyelitis, and autonomic neuropathy suggests that these diseases are different manifestations of the same nosologic process. With one exception, treatment of the tumor, immunosuppressive drugs, and plasmapheresis did not influence the course of the neurologic illness. The autoantibody was not identified in sera from more than 400 controls subjects, including patients with SSN associated with other tumors, SSN without malignancy, other paraneoplastic syndromes, and SCLC without neurologic symptoms. The autoantibody is a highly specific marker of the paraneoplastic syndromes associated with SCLC and its detection in a patient not known to have cancer should prompt a careful search for SCLC.
Address correspondence and reprint requests to Dr. Posner, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021.
Dr. Anderson was supported, in part, by funds granted by the New Zealand Neurological Foundation and the Norman and Rosita Winston Foundation.
Presented in part at the fortieth annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.
Received November 20, 1987. Accepted for publication in final form January 18, 1988.
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