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Paraneoplastic demyelinating neuropathy, subacute sensory neuropathy, and anti-hu antibodies: Clinicopathological study of an autopsy case

✍ Scribed by Jean-Christophe Antoine; Jean-François Mosnier; Jérôme Honnorat; Philippe Convers; Léna Absi; Jérôme Lapras; Daniel Michel


Publisher
John Wiley and Sons
Year
1998
Tongue
English
Weight
622 KB
Volume
21
Category
Article
ISSN
0148-639X

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✦ Synopsis


A patient with anti-Hu antibodies, small-cell lung carcinoma, and autopsy-proven subacute sensory neuropathy had early slowing of motor and sensory conduction velocities. In the peripheral nerves, chronic demyelinating and remyelinating lesions with axonal degeneration were associated with an inflammatory reaction consisting of CD8+ T cells and CD68+ macrophages. On immunohistochemical testing, the patient's serum did not react with normal nerve, suggesting that the Hu proteins were not the target of the inflammatory reaction in the nerve.


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A previously reported patient presenting sensory-dominant neuropathy with antiganglioside antibodies, bound preferentially to polysialogangliosides including GD1b, was autopsied. While axonal degeneration was predominant in the sural nerve, many demyelinated fibers were present in the spinal roots.