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Last edited on June 1, 2023

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--- cl:paraneoplastic-disorders [on June 1, 2023]
psychdb [Psychiatric]
+++ cl:paraneoplastic-disorders [on June 1, 2023]
psychdb [Primer]
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 {{INLINETOC}}
 ===== Primer =====
-**Paraneoplastic disorders** can lead to severe psychiatric and behavioural symptoms. Rapid identification is required to ensure correct treatment and management to avoid misdiagnosis of a paraneoplastic neurologic disorder. Paraneoplastic neurological syndromes (PNS) are the immune-mediated effects of a remote cancer and are characterized by an autoantibody response against the antigens expressed by the tumour.
+**Paraneoplastic disorders** can lead to severe psychiatric and behavioural symptoms. **Paraneoplastic limbic encephalitis (PLE)** is a rare neurological syndrome associated with cancer, and selectively affects limbic system structures, including the hippocampus, hypothalamus, and amygdala.[([[https://pubmed.ncbi.nlm.nih.gov/29717222/|Shen, K., Xu, Y., Guan, H., Zhong, W., Chen, M., Zhao, J., ... & Wang, M. (2018). Paraneoplastic limbic encephalitis associated with lung cancer. Scientific reports, 8(1), 1-8.]])] The encephalitis is caused by an altered immunologic response to a malignancy that has antigens that resemble limbic antigens. The inflammatory response, however, occurs away from the original neoplasm site.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319301/|Kacem, M., Belloumi, N., Bachouche, I., Mersni, M., Chermiti Ben Abdallah, F., & Fenniche, S. (2018). Paraneoplastic limbic encephalitis revealing a small cell carcinoma of the lung. Respiratory medicine case reports, 26, 157–160.]])]
-===== Psychiatric =====
-This autoantibody response can be psychiatric in nature, and includes:
-  * [[cl:0-autoimmune-encephalitis:anti-nmda-receptor|NMDAR-antibody encephalitis]]
-  * Ophelia syndrome, associated with surface- directed mGluR5-antibodies (seen in patients with Hodgkin’s lymphoma)
-===== Paraneoplastic Limbic Encephalitis =====
 <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See main article: **[[cl:0-autoimmune-encephalitis:home]]**</alert>
-**Paraneoplastic limbic encephalitis (PLE)** is a rare neurological syndrome associated with cancer, and selectively affects limbic system structures, including the hippocampus, hypothalamus, and amygdala.[([[https://pubmed.ncbi.nlm.nih.gov/29717222/|Shen, K., Xu, Y., Guan, H., Zhong, W., Chen, M., Zhao, J., ... & Wang, M. (2018). Paraneoplastic limbic encephalitis associated with lung cancer. Scientific reports, 8(1), 1-8.]])] It is usually associated with small cell lung cancer. The encephalitis is caused by an altered immunologic response to a malignancy that has antigens that resemble limbic antigens. The inflammatory response, however, occurs away from the original neoplasm site.
-[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319301/|Kacem, M., Belloumi, N., Bachouche, I., Mersni, M., Chermiti Ben Abdallah, F., & Fenniche, S. (2018). Paraneoplastic limbic encephalitis revealing a small cell carcinoma of the lung. Respiratory medicine case reports, 26, 157–160.]])]
+===== Autoantibodies =====
+The autoantibody response can be psychiatric in nature, and includes:
+  * **[[cl:0-autoimmune-encephalitis:anti-nmda-receptor|NMDAR-antibody encephalitis]]**, associated with ovarian teratomas in younger women
+  * Ophelia syndrome, associated with surface-directed **mGluR5-antibodies**, seen in patients with Hodgkin’s lymphoma
+  * **Anti-neuronal nuclear antibody-1 (ANNA-1)**, also known as **Hu** paraneoplastic encephalomyelitis, associated with small cell lung cancer in 75% of cases (other tumours include lung, prostate, breast, bladder, GI tract, ovary, neuroendocrine, unknown origin), most commonly in men.
+  * **AMPA receptor antibodies**, associated with lung, breast, thymus, ovarian tumours.
 ==== Diagnosis ====