Paraneoplastic chorea associated with CRMP-5 neuronal antibody and lung carcinoma.
Paraneoplastic chorea is described in 16 patients: 11 with limited small-cell carcinoma, 2 with lung cancer revealed by imaging, 1 with renal cell carcinoma, and 1 with lymphoma. All had CRMP-5-IgG; 6 also had ANNA-1 (anti-Hu), including 1 without evident cancer. Chorea was the initial and most prominent symptom in 11 patients, asymmetric or unilateral in 5 patients, and part of a multifocal syndrome in 14 patients. Basal ganglia abnormalities were revealed by magnetic resonance imaging and at autopsy (as perivascular inflammation and microglial activation). Four patients improved with chemotherapy, and 2 improved with intravenous methylprednisolone.
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. verns@mayo.edu
Steven
S
Vernino
Paul
P
Tuite
Charles H
CH
Adler
James F
JF
Meschia
Bradley F
BF
Boeve
Peter
P
Boasberg
Joseph E
JE
Parisi
Vanda A
VA
Lennon
D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D018288:Carcinoma, Small Cell / Q000097:blood* / Q000150:complications / Q000473:pathology; D002819:Chorea / Q000097:blood* / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000097:blood* / Q000276:immunology; D020361:Paraneoplastic Syndromes, Nervous System / Q000097:blood* / Q000150:complications / Q000473:pathology; D011446:Prospective Studies
D001323:Autoantibodies; D009419:Nerve Tissue Proteins