Anti-neuronal nuclear autoantibody type 2: Paraneoplastic accompaniments

Research output: Contribution to journalArticle

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Abstract

We identified the IgG autoantibody ANNA-2 ("anti-Ri") in 34 patients in a 12-year period by immunofluorescence screening of sera from approximately 75,000 patients with subacute neurological disorders that were suspected to be paraneoplastic. Detailed clinical information was available for 28 patients (10 men, 18 women). Cancer was diagnosed in 24 patients (86%); 21 had histologically proven carcinoma (10 lung, 9 breast, 1 cervical, 1 bladder), and 3 had an intrathoracic imaging abnormality. Cancer anteceded neurological symptoms in 4 of 28 patients. Cancer detection frequency increased with continued surveillance. Neurological disorders, in decreasing frequency, were brainstem syndrome (including opsoclonus, myoclonus, or both), cerebellar syndrome, myelopathy, peripheral neuropathy, cranial neuropathy, movement disorder, encephalopathy, Lambert-Eaton syndrome, and seizures. Four patients had laryngospasm and four had jaw opening dystonia (two with neck dystonia). Nine (32%) were wheelchair-bound 1 month after neurological symptom onset. Most improved neurologically after immunomodulatory or tumor-directed therapy. Accompanying autoantibodies, found in 73% of sera, included ANNA-1, ANNA-3, CRMP-5-IgG, P/Q-type and N-type Ca2+ channel antibodies, and muscle-type acetylcholine receptor antibody. Some neurological accompaniments of ANNA-2 may reflect potentially pathogenic humoral or cell-mediated responses to coimmunogenic tumor antigens, for example, LambertEaton syndrome (P/Q-type Ca2+ channel antibody) and peripheral neuropathy (ANNA-1 effector T cells).

Original languageEnglish (US)
Pages (from-to)580-587
Number of pages8
JournalAnnals of Neurology
Volume53
Issue number5
DOIs
StatePublished - May 1 2003

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Autoantibodies
Dystonia
Peripheral Nervous System Diseases
Nervous System Diseases
Antibodies
Neoplasms
Opsoclonus-Myoclonus Syndrome
Immunoglobulin G
Lambert-Eaton Myasthenic Syndrome
Laryngismus
Cerebellar Diseases
Cranial Nerve Diseases
Wheelchairs
Spinal Cord Diseases
Movement Disorders
Brain Diseases
Cholinergic Receptors
Neoplasm Antigens
Jaw
Serum

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Anti-neuronal nuclear autoantibody type 2 : Paraneoplastic accompaniments. / Pittock, Sean J; Lucchinetti, Claudia F; Lennon, Vanda A.

In: Annals of Neurology, Vol. 53, No. 5, 01.05.2003, p. 580-587.

Research output: Contribution to journalArticle

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