Статья: Паранеопластические энцефаломиелиты

Внимание! Если размещение файла нарушает Ваши авторские права, то обязательно сообщите нам

Рекомендуемое обследование включает анализ сыворотки и ЦСЖ на наличие специфических антител, МРТ, ПЭТ КТ, ЭЭГ и онкологический скрининг.

Лечение включает оперативное удаление первичной опухоли и использование терапии, направленной на Т-клетки, включая такие препараты как циклофосфамид, ГКС и такролимус при классическом ПЭМ, а также плазмаферез или ГКС при неклассическом ПЭМ.

Для улучшения прогноза заболевания необходимо придерживаться тактики онконастороженности у пациентов с опухолевыми заболеваниями в отношении неврологических ПНС.

Использованные источники

1. Dalmau J, Gultekin HS, Posner JB. Paraneoplastic neurologic syndromes: pathogenesis and physiopathology. Brain Pathol. 1999 Apr;9(2):275-84.

2. Sinmaz N, Nguyen T, Tea F, Dale RC, Brilot F. Mapping autoantigen epitopes: molecular insights into autoantibody-associated disorders of the nervous system. J Neuroinflammation. 2016 Aug 30;13(1):219.

3. Graus F, Delattre JY, Antoine JC, Dalmau J, Giometto B, Grisold W, Honnorat J, Smitt PS, Vedeler Ch, Verschuuren JJ, Vincent A, Voltz R. Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry. 2004 Aug;75(8):1135-40.

4. Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, Cortese I, Dale RC, Gelfand JM, Geschwind M, Glaser CA, Honn orat J, Hoftberger R, Iizuka T, Irani SR, Lancaster E, Leypoldt F, Pruss H, Rae-Grant A, Reindl M, Rosenfeld MR, Rostasy K, Saiz A, Venkatesan A, Vincent A, Wandinger KP, Waters P, Dalmau J. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016 Apr;15(4):391-404.

5. Tanaka K, Kawamura M, Sakimura K, Kato N. Significance of Autoantibodies in Autoimmune Encephalitis in Relation to Antigen Localization: An Outline of Frequently Reported Autoantibodies with a Non-Systematic Review. Int J Mol Sci. 2020 Jul 13;21(14)

6. Trenevska I, Li D, Banham AH. Therapeutic Antibodies against Intracellular Tumor Antigens. Front Immunol. 2017;8:1001. [PMC free article]

7. Hansen N, Grunewald B, Weishaupt A, Cola?o MN, Toyka KV, Sommer C, Geis C. Human Stiff person syndrome IgG-containing high-titer anti-GAD65 autoantibodies induce motor dysfunction in rats. Exp Neurol. 2013 Jan;239:202

8. Iorio R, Damato V, Spagni G, Della Marca G, Vollono C, Masi G, Papi C,

Campetella L, Monte G, Evoli A. Clinical characteristics and outcome of patients with autoimmune encephalitis: clues for paraneoplastic aetiology. Eur J Neurol. 2020 Oct;27(10):2062-2071.

9. Dalmau J, Geis C, Graus F. Autoantibodies to Synaptic Receptors and Neuronal Cell Surface Proteins in Autoimmune Diseases of the Central Nervous System. Physiol Rev. 2017 Apr;97(2):839-887.

10. Dalmau J, Graus F. Antibody-Mediated Encephalitis. N Engl J Med. 2018 Mar 01;378(9):840-851.

11. Vogrig A, Muniz-Castrillo S, Desestret V, Joubert B, Honnorat J. Pathophysiology of paraneoplastic and autoimmune encephalitis: genes, infections, and checkpoint inhibitors. Ther Adv Neurol Disord. 2020;13:1756286420932797.

12. Graus F, Dalmau J. Paraneoplastic neurological syndromes in the era of immune-checkpoint inhibitors. Nat Rev Clin Oncol. 2019 Sep;16(9):535-548.

13. Galli J, Greenlee J. Paraneoplastic Diseases of the Central Nervous System. F1000Res. 2020;9

14. Darnell RB, Posner JB. Paraneoplastic syndromes involving the nervous system. N Engl J Med. 2003 Oct 16;349(16): 1543-54.

15. Kanikannan MA, Sirisha Y, Uppin MS, Jabeen SA, Kandadai RM, Sundaram C, Raghunadharao D, Borgohain R. Incidence and spectrum of paraneoplastic neurological syndromes: single center study. J Neurooncol. 2015 Oct;125(1):197- 206.

16. Honnorat J, Antoine JC. Paraneoplastic neurological syndromes. Orphanet J Rare Dis. 2007 May 04;2:22.

17. Dalmau J, Graus F, Rosenblum MK, Posner JB. Anti-Hu--associated paraneoplastic encephalomyelitis/sensory neuronopathy. A clinical study of 71 patients. Medicine (Baltimore). 1992 Mar;71(2):59-72.

18. Darnell RB, DeAngelis LM. Regression of small-cell lung carcinoma in patients with paraneoplastic neuronal antibodies. Lancet. 1993 Jan 02;341(8836):21-2.

19. Shen K, Xu Y, Guan H, Zhong W, Chen M, Zhao J, Li L, Wang M. Paraneoplastic limbic encephalitis associated with lung cancer. Sci Rep. 2018 May 01;8(1):6792.

20. Shams'ili S, Grefkens J, de Leeuw B, van den Bent M, Hooijkaas H, van der Holt B, Vecht C, Sillevis Smitt P. Paraneoplastic cerebellar degeneration associated with antineuronal antibodies: analysis of 50 patients. Brain. 2003 Jun;126(Pt 6): 1409-18.

21. Popkirov S, Ayzenberg I, Hahn S, Bauer J, Denno Y, Rieckhoff N, Radzimski C, Hans VH, Berg S, Roghmann F, Noldus J, Bien CG, Skodda S, Wellmer J, Stocker W, Krogias C, Gold R, Schlegel U, Probst C, Komorowski L, Miske R, Kleiter I. Rho-associated protein kinase 2 (ROCK2): a new target of autoimmunity in paraneoplastic encephalitis. Acta Neuropathol Commun. 2017 May 29;5(1):40.

22. Mandel-Brehm C, Dubey D, Kryzer TJ, O'Donovan BD, Tran B, Vazquez SE, Sample HA, Zorn KC, Khan LM, Bledsoe IO, McKeon A, Pleasure SJ, Lennon VA, DeRisi JL, Wilson MR, Pittock SJ. Kelch-like Protein 11 Antibodies in Seminoma- Associated Paraneoplastic Encephalitis. N Engl J Med. 2019 Jul 04;381(1):47-54.

23. Bien CG, Schanzer A, Dargvainiene J, Dogan-Onugoren M, Woermann F, Strickler A. Co-occurrence of antibodies against dipeptidyl-peptidase-like protein-6 and aquaporin-4 during a case of paraneoplastic encephalitis. Clin Neurol Neurosurg. 2020 Oct;197:106093.

24. Lim TT. Paraneoplastic autoimmune movement disorders. Parkinsonism Relat Disord. 2017 Nov;44:106-109.

25. Tuzun E, Zhou L, Baehring JM, Bannykh S, Rosenfeld MR, Dalmau J. Evidence for antibody-mediated pathogenesis in anti-NMDAR encephalitis associated with ovarian teratoma. Acta Neuropathol. 2009 Dec;118(6):737-43.

26. Barry H, Byrne S, Barrett E, Murphy KC, Cotter DR. Anti-N-methyl-d- aspartate receptor encephalitis: review of clinical presentation, diagnosis and treatment. BJPsych Bull. 2015 Feb;39(1):19-23.

27. Henson RA, Hoffman HL, Urich H. Encephalomyelitis with carcinoma. Brain. 1965 Sep;88(3):449-64.

28. Grativvol RS, Cavalcante WCP, Castro LHM, Nitrini R, Simabukuro MM. Updates in the Diagnosis and Treatment of Paraneoplastic Neurologic Syndromes. Curr Oncol Rep. 2018 Nov 10;20(11):92.

29. Voltz R, Gultekin SH, Rosenfeld MR, Gerstner E, Eichen J, Posner JB, Dalmau J. A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer. N Engl J Med. 1999 Jun 10;340(23):1788-95.

30. Malek N, Damian M. Trismus caused by paraneoplastic brainstem encephalitis. Pract Neurol. 2018 Apr;18(2):146-150.

31. Moragas M, Martinez-Yelamos S, Majos C, Fernandez-Viladrich P, Rubio F, Arbizu T. Rhombencephalitis: a series of 97 patients. Medicine (Baltimore). 2011 Jul;90(4):256-261.

32. Pillay N, Gilbert JJ, Ebers GC, Brown JD. Internuclear ophthalmoplegia and "optic neuritis": paraneoplastic effects of bronchial carcinoma. Neurology. 1984 Jun;34(6):788-91.

33. Saiz A, Bruna J, Stourac P, Vigliani MC, Giometto B, Grisold W, Honnorat J, Psimaras D, Voltz R, Graus F. Anti-Hu-associated brainstem encephalitis. J Neurol Neurosurg Psychiatry. 2009 Apr;80(4):404-7.

34. Sarva H, Deik A, Ullah A, Severt WL. Clinical Spectrum of Stiff Person Syndrome: A Review of Recent Reports. Tremor Other Hyperkinet Mov (N Y). 2016;6:340. [PMC free article]

35. Murinson BB, Guarnaccia JB. Stiff-person syndrome with amphiphysin antibodies: distinctive features of a rare disease. Neurology. 2008 Dec 09;71(24):1955-8. [PMC free article]

36. El-Abassi R, Soliman MY, Villemarette-Pittman N, England JD. SPS: Understanding the complexity. J Neurol Sci. 2019 Sep 15 ;404:137-149.

37. Seluk L, Taliansky A, Yonath H, Gilburd B, Amital H, Shoenfeld Y, Kivity S. A large screen for paraneoplastic neurological autoantibodies; diagnosis and predictive values. Clin Immunol. 2019 Feb;199:29-36.

38. Drlicek M, Bianchi G, Bogliun G, Casati B, Grisold W, Kolig C, Liszka- Setinek U, Marzorati L, Wondrusch E, Cavaletti G. Antibodies of the anti-Yo and anti-Ri type in the absence of paraneoplastic neurological syndromes: a long-term survey of ovarian cancer patients. J Neurol. 1997 Feb;244(2):85-9.

39. Bataller L, Wade DF, Graus F, Stacey HD, Rosenfeld MR, Dalmau J. Antibodies to Zic4 in paraneoplastic neurologic disorders and small-cell lung cancer. Neurology. 2004 Mar 09;62(5):778-82. [PMC free article]

40. Graus F, Dalmou J, Rene R, Tora M, Malats N, Verschuuren JJ, Cardenal F, Vinolas N, Garcia del Muro J, Vadell C, Mason WP, Rosell R, Posner JB, Real FX.

Anti-Hu antibodies in patients with small-cell lung cancer: association with complete response to therapy and improved survival. J Clin Oncol. 1997 Aug;15(8):2866-72.

41. Dalmau J, Furneaux HM, Gralla RJ, Kris MG, Posner JB. Detection of the anti-Hu antibody in the serum of patients with small cell lung cancer--a quantitative western blot analysis. Ann Neurol. 1990 May;27(5):544-52.

42. Pittock SJ, Kryzer TJ, Lennon VA. Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol. 2004 Nov;56(5):715-9.

43. McKeon A, Tracy JA, Pittock SJ, Parisi JE, Klein CJ, Lennon VA. Purkinje cell cytoplasmic autoantibody type 1 accompaniments: the cerebellum and beyond. Arch Neurol. 2011 Oct;68(10):1282-9.

44. Padda SK, Yao X, Antonicelli A, Riess JW, Shang Y, Shrager JB, Korst R, Detterbeck F, Huang J, Burt BM, Wakelee HA, Badve SS. Paraneoplastic Syndromes and Thymic Malignancies: An Examination of the International Thymic Malignancy Interest Group Retrospective Database. J Thorac Oncol. 2018 Mar;13(3):436-446. [PMC free article]

45. Gong L, Zhang P, Liu XY, Fang M. A rare thymoma case with seven paraneoplastic syndromes. Int J Clin Exp Med. 2015;8(10):19517-23.

46. Zhao J, Bhatnagar V, Ding L, Atay SM, David EA, McFadden PM, Stamnes S, Lechtholz-Zey E, Wightman SC, Detterbeck FC, Kim AW. A systematic review of paraneoplastic syndromes associated with thymoma: Treatment modalities, recurrence, and outcomes in resected cases. J Thorac Cardiovasc Surg. 2020 Jul;160(1):306-314.e14.

47. Baysal-Kirac L, Tuzun E, Altindag E, Ekizoglu E, Kinay D, Bilgic B, Tekturk P, Baykan B. Are There Any Specific EEG Findings in Autoimmune Epilepsies? Clin EEG Neurosci. 2016 Jul;47(3):224-34.

48. Baykan B, Gungor Tuncer O, Vanli-Yavuz EN, Baysal Kirac L, Gundogdu G, Bebek N, Gurses C, Altindag E, Tuzun E. Delta Brush Pattern Is Not Unique to NMDAR Encephalitis: Evaluation of Two Independent Long-Term EEG Cohorts. Clin EEG Neurosci. 2018 Jul;49(4):278-284.

49. Vanli-Yavuz EN, Erdag E, Tuzun E, Ekizoglu E, Baysal-Kirac L, Ulusoy C, Peach S, Gundogdu G, Sencer S, Sencer A, Kucukali CI, Bebek N, Gurses C, Gokyigit A, Baykan B. Neuronal autoantibodies in mesial temporal lobe epilepsy with hippocampal sclerosis. J Neurol Neurosurg Psychiatry. 2016 Jul;87(7):684

50. Basu S, Alavi A. Role of FDG-PET in the clinical management of paraneoplastic neurological syndrome: detection of the underlying malignancy and the brain PET-MRI correlates. Mol Imaging Biol. 2008 May-Jun;10(3):131-7.

51. Yuan J, Jia Z, Qin W, Hu W. Paraneoplastic neuromyelitis optica spectrum disorder associated with breast cancer. Clin Interv Aging. 2019;14:1039-1044.

52. Bernard-Valnet R, Cobo-Calvo A, Siegfried A, Marasescu R, Bonnan M, Ballan G, Ellie E, Bauer J, Uro-Coste E, Marignier R, Brassat D. Paraneoplastic neuromyelitis optica and ovarian teratoma: A case series. Mult Scler Relat Disord. 2019 Jun;31:97-100.

53. Flanagan EP, McKeon A, Lennon VA, Kearns J, Weinshenker BG, Krecke KN, Matiello M, Keegan BM, Mokri B, Aksamit AJ, Pittock SJ. Paraneoplastic isolated myelopathy: clinical course and neuroimaging clues. Neurology. 2011 Jun 14;76(24):2089-95.

54. Titulaer MJ, Soffietti R, Dalmau J, Gilhus NE, Giometto B, Graus F, Grisold W, Honnorat J, Sillevis Smitt PA, Tanasescu R, Vedeler CA, Voltz R, Verschuuren JJ., European Federation of Neurological Societies. Screening for tumours in paraneoplastic syndromes: report of an EFNS task force. Eur J Neurol. 2011 Jan;18(1):19-e3.

55. Rosenfeld MR, Dalmau J. Current Therapies for Paraneoplastic Neurologic Syndromes. Curr Treat Options Neurol. 2003 Jan;5(1):69-77.

56. Vernino S, O'Neill BP, Marks RS, O'Fallon JR, Kimmel DW. Immunomodulatory treatment trial for paraneoplastic neurological disorders. Neuro Oncol. 2004 Jan;6(1):55-62.

57. Honnorat J, Didelot A, Karantoni E, Ville D, Ducray F, Lambert L, Deiva K, Garcia M, Pichit P, Cavillon G, Rogemond V, DeLattre JY, Tardieu M. Autoimmune limbic encephalopathy and anti-Hu antibodies in children without cancer. Neurology. 2013 Jun 11;80(24):2226-32.

58. de Montmollin E, Demeret S, Brule N, Conrad M, Dailler F, Lerolle N, Navellou JC, Schwebel C, Alves M, Cour M, Engrand N, Tonnelier JM, Maury E, Ruckly S, Picard G, Rogemond V, Magalhaes E, Sharshar T, Timsit JF, Honnorat J, Sonneville R., ENCEPHALITICA Study Group | Anti-N-Methyl-d-Aspartate Receptor Encephalitis in Adult Patients Requiring Intensive Care. Am J Respir Crit Care Med. 2017 Feb 15;195(4):491-499.

59. Ducray F, Graus F, Vigliani MC, Antoine JC, Rogemond V, Saiz A, Honnorat J. Delayed onset of a second paraneoplastic neurological syndrome in eight patients. J Neurol Neurosurg Psychiatry. 2010 Aug;81(8):937-9.