Anti-alpha-enolase antibodies in cancer-associated retinopathy with small cell carcinoma of the lung.
OBJECTIVE
To present a case of cancer-associated retinopathy (CAR) in a patient with small cell carcinoma of the lung and antiretinal antibodies who experienced visual symptoms before diagnosis of cancer.


METHODS
Case report.


METHODS
A 61-year-old man with a sudden loss of vision and photophobia was referred to the ophthalmology service. Antiretinal antibodies were determined by Western blot analysis.


RESULTS
The patient was found to have small cell carcinoma of the lung without metastasis and was surgically treated. His visual loss was asymmetrical. The full field ERG was normal, even though his vision in the right eye became progressively worse. The patient was treated with methylprednisolone and showed significant improvement. Before surgery, serum tests showed antiretinal protein 35-kD; 1 week after surgery, antiretinal protein 35-kD and 46-kD (alpha-enolase); and 1 month after surgery, anti-alpha-enolase.


CONCLUSIONS
Typical visual symptoms for paraneoplastic retinopathy are not always present. The absence of antirecoverin antibodies does not exclude a diagnosis of CAR.
Dot
Corinne
C
Department of Ophthalmology and Pulmonary Medicine, HIA Percy, 101 bd H. Barbusse, 92141 Clamart cedex, France.
Guigay
Joël
J
Adamus
Grazyna
G
D001323:Autoantibodies / Q000097:blood*; D014408:Biomarkers, Tumor; D015153:Blotting, Western; D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000601:surgery; D004268:DNA-Binding Proteins / Q000276:immunology*; D004596:Electroretinography; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D010751:Phosphopyruvate Hydratase / Q000276:immunology*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D025521:Tumor Suppressor Proteins / Q000276:immunology*; D058609:Visual Field Tests; D014794:Visual Fields
D001323:Autoantibodies; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D005938:Glucocorticoids; D025521:Tumor Suppressor Proteins; C095157:ENO1 protein, human; D010751:Phosphopyruvate Hydratase