Anti-Hu Antibody-associated Paraneoplastic Neurological Syndrome Showing Peripheral Neuropathy and Atypical Multifocal Brain Lesions

Makoto Shibata; Megumi Uchida; Setsuki Tsukagoshi; Koichi Yamaguchi; Aya Yamaguchi; Natsumi Furuta; Kouki Makioka; Toshitaka Maeno; Yukio Fujita; Masahiko Kurabayashi; Yoshio Ikeda

doi:10.2169/internalmedicine.54.4867

CASE REPORTS

Anti-Hu Antibody-associated Paraneoplastic Neurological Syndrome Showing Peripheral Neuropathy and Atypical Multifocal Brain Lesions

Makoto Shibata, Megumi Uchida, Setsuki Tsukagoshi, Koichi Yamaguchi, Aya Yamaguchi, Natsumi Furuta, Kouki Makioka, Toshitaka Maeno, Yukio Fujita, Masahiko Kurabayashi, Yoshio Ikeda

Author information

Makoto Shibata
Department of Neurology, Gunma University Graduate School of Medicine, Japan
Megumi Uchida
Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
Setsuki Tsukagoshi
Department of Neurology, Gunma University Graduate School of Medicine, Japan
Koichi Yamaguchi
Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
Aya Yamaguchi
Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
Natsumi Furuta
Department of Neurology, Gunma University Graduate School of Medicine, Japan
Kouki Makioka
Department of Neurology, Gunma University Graduate School of Medicine, Japan
Toshitaka Maeno
Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
Yukio Fujita
Department of Neurology, Gunma University Graduate School of Medicine, Japan
Masahiko Kurabayashi
Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Japan
Yoshio Ikeda
Department of Neurology, Gunma University Graduate School of Medicine, Japan

Keywords: paraneoplastic neurological syndrome (PNS), anti-Hu antibody, small-cell lung cancer (SCLC), peripheral neuropathy, cauda equina enhancement, encephalopathy

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 23 Pages 3057-3060

DOI https://doi.org/10.2169/internalmedicine.54.4867

Details

Abstract

A 64-year-old Japanese woman presented with a three-month history of progressive numbness and weakness of the lower extremities. A neurological examination and nerve conduction study indicated sensorimotor polyneuropathy. Since the serum anti-Hu antibody titer was remarkably elevated, paraneoplastic neurological syndrome was highly suspected. A thoracoscopic biopsy of the hilar lymph nodes, in which ¹⁸F-fluorodeoxyglucose uptake was obviously increased, revealed pathological findings for small-cell lung cancer (SCLC). Subsequently, the patient presented with generalized tonic-clonic seizures, and cerebral MRI showed reversible multifocal brain lesions, considered to reflect paraneoplastic encephalopathy. After two courses of chemotherapy for SCLC, the brain lesions totally disappeared.

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