Immunohistochemical analysis of the immune reaction in the nervous system in paraneoplastic encephalomyelitis.
We examined frozen sections of frontal cortex, medulla, and dorsal root ganglia from a patient with small-cell lung cancer and paraneoplastic encephalomyelitis, involving the medulla and dorsal root ganglia, with a panel of antibodies reactive for IgG, IgM, C3, B cells, T cells, T cell subsets, macrophages, and class I and II (HLA-DR) major histocompatibility complex (MHC) antigens. We detected an antineuronal antibody (anti-Hu) in the serum and CSF of the patient and found deposits of IgG in the periphery of some neurons in dorsal root ganglia. The infiltrates were almost exclusively T cells with a predominance of CD8-positive cells. Neurons did not express class I or II MHC antigens. Satellite cells in the dorsal root ganglia from the patient and controls were HLA-DR-positive. These data indicate that CD8-positive T cells predominate in the inflammatory infiltrates of paraneoplastic encephalomyelitis. IgG deposits may be relevant in the damage of the sensory neurons.
Department of Neurology, Hospital Clinic i Provincial, Barcelona, Spain.
F
F
Graus
T
T
Ribalta
E
E
Campo
R
R
Monforte
A
A
Urbano
C
C
Rozman
D000911:Antibodies, Monoclonal; D004679:Encephalomyelitis / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*; D005455:Fluorescent Antibody Technique; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D009420:Nervous System / Q000032:analysis*; D010257:Paraneoplastic Syndromes / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*
D000911:Antibodies, Monoclonal