Intravenous immunoglobulin therapy in paraneoplastic neurological syndromes.
Combining clinical and immunological information, a neurological syndrome can now be diagnosed as a "definite" or "possible" paraneoplastic syndrome according to the newly suggested diagnostic criteria of the PNS Euronetwork. Differentiated diagnosis of a paraneoplastic syndrome is essential for differential therapy in patients. According to the response to IVIG therapy, paraneoplastic disorders may be subgrouped in group A, a clinical response is the rule (prototype Lambert-Eaton myasthenic syndrome), and in group B, IVIG may be helpful in single patients and is indicated in specific clinical settings (prototype anti-Hu associated neurological syndromes). The mode of action of IVIG may range from direct anti-idiotype effect to indirect effects on the cellular part of the pathogenesis of paraneoplastic syndromes. Due to the therapeutic relevance, it is therefore important to diagnose a PND as early as possible, and start immunotherapy including IVIG immediately.
Voltz
Raymond
R
Department of Palliative Medicine, University Hospital, Kerpener Str. 62, 50924, Köln, Germany. raymond.voltz@uk-koeln.de
D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D020364:Paraneoplastic Polyneuropathy / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology
D016756:Immunoglobulins, Intravenous