title: Intrathecal synthesis of anti-Hu antibodies distinguishes patients with paraneoplastic peripheral neuropathy and encephalitis.
abstract: BACKGROUND
  Paraneoplastic syndromes are serious immune caused diseases of the peripheral and/or central nervous system associated with malignant neoplasm. Symptoms develop when antibodies against antigens expressed by tumor cells cross-react with neuronal proteins. Antineuronal antibodies are usually examined in patient's sera while examination of the cerebrospinal fluid (CSF) often fails. Furthermore, the few previous reports describing CSF data summarized different antineuronal antibodies and/or regarded patients with different neurological symptoms as one group.
  
  
  METHODS
  We retrospectively evaluated data of 18 patients with paraneoplastic syndromes due to anti-Hu antibodies. The study aimed to differentiate patients with peripheral neuropathy and encephalitis by cerebrospinal fluid (CSF) parameters including anti-Hu antibody titers.
  
  
  RESULTS
  Our results confirm previous observations that serum titers of anti-Hu antibodies and standard CSF values do not differ between patients with neuropathy and encephalitis. However, analysis of CSF anti-Hu titers and calculating the intrathecal synthesis helped to discriminate between both groups.
  
  
  CONCLUSIONS
  In conclusion, our results indicate that patients even with one defined antineuronal antibody need to be regarded separately depending on the involved location of the nervous system. We recommend incorporation of anti-Hu analyses in the CSF and calculating the intrathecal synthesis in patients with anti-Hu syndrome.
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Philipp
authors: P
authors: Schwenkenbecher
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Lisa Priya
authors: LP
authors: Chacko
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Ulrich
authors: U
authors: Wurster
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Kaweh
authors: K
authors: Pars
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Refik
authors: R
authors: Pul
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Kurt-Wolfram
authors: KW
authors: Sühs
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany.
authors: Martin
authors: M
authors: Stangel
authors: Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hanover, Germany. Skripuletz.Thomas@MH-Hannover.de.
authors: Thomas
authors: T
authors: Skripuletz
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid*; D051959:ELAV Proteins; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020361:Paraneoplastic Syndromes, Nervous System / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies; D051959:ELAV Proteins