Biomedical subjects

Edward J Dropcho

Publications and source records attributed to Edward J Dropcho.

6 recordsLinked to original sources

PubMed2005

Anti-Hu antibody neuropathy: a clinical, electrophysiological, and pathological study.

OBJECTIVE: The objective is to report the clinical, electrophysiological, and histopathological features of 16 patients with anti-Hu antibody neuropathy. METHODS: Clinical and electrophysiological data in 16 patients (11 females and 5 males) with positive anti-Hu antibody and nerve biopsy data in 9 cases were analyzed. RESULTS: Cancer was detected in 11 patients, including 9 with small-cell lung cancer. Classical paraneoplastic subacute sensory neuronopathy (SSN) and/or encephalomyelitis (EM) was observed in 7 patients (44%), including 5 with SSN. The most common clinical feature was sensory-motor neuropathy (SMN), accounting for 50% of cases. Though sensory nerve conduction abnormality was the prominent feature in 14 (88%) cases, sensory and motor nerve conduction was abnormal in all cases. Motor nerve conduction findings were typical of axonal degeneration. The most common nerve conduction pattern was that of SMN, with a sensory neuronopathy pattern being observed in only 3 cases. Sural nerve biopsy in 9 patients showed axonal degeneration in all cases and inflammatory cells in 4 cases. CONCLUSIONS: Classical sensory neuronopathy is rarer than expected, both clinically and electrophysiologically. Motor involvement is not uncommon and motor nerve conduction abnormality is frequently seen. A diverse clinical and electrophysiological, and histopathological spectrum was observed in this neuropathy. SIGNIFICANCE: New guidelines for the selection of patients for anti-Hu antibody test are recommended.

Action Potentials↗

PubMed2005

Update on paraneoplastic syndromes.

PURPOSE OF REVIEW: This review discusses the varied clinical spectrum of neurologic paraneoplastic disorders, describes recent advances in our understanding of autoimmunity in these disorders, and outlines a practical clinical approach to patient management. RECENT FINDINGS: Paraneoplastic disorders may affect any part of the central or peripheral nervous system. Although relatively uncommon, these disorders are a significant cause of severe and permanent neurologic disability. Syndromes such as limbic encephalitis or opsoclonus-myoclonus should always raise suspicion of a paraneoplastic condition, but any paraneoplastic syndrome can also occur in patients without a neoplasm. Most neurologic paraneoplastic disorders are thought to be caused by an autoimmune reaction directed against 'onconeural' antigens expressed by neurons and tumor cells. Some syndromes such as Lambert-Eaton myasthenic syndrome and neuromyotonia are clearly mediated by autoantibodies. Much less is known about the immunopathogenesis of syndromes that affect the central nervous system, although a growing body of evidence implicates cellular immune effectors in causing neuronal injury. Many patients have circulating antineuronal antibodies, which can be useful in identifying a neurologic disorder as paraneoplastic and in finding the associated neoplasm. Early diagnosis of the neurologic disorder and prompt initiation of tumor treatment probably increase the likelihood of neurologic improvement. SUMMARY: Neurologists must be able to recognize the clinical manifestations of neurologic paraneoplastic disorders, and to distinguish them from other causes of neurologic dysfunction in cancer patients. Early diagnosis of paraneoplastic syndromes maximizes the likelihood of a favorable oncologic and neurologic outcome.

Autoantibodies↗

PubMed2005

Immunotherapy for paraneoplastic neurological disorders.

Paraneoplastic disorders may affect any part of the central or peripheral nervous systems. Although relatively uncommon, these disorders are a significant cause of severe neurological disability among cancer patients. Most, if not all, neurological paraneoplastic disorders are believed to be autoimmune diseases in which an antitumour immune response also attacks neurons that express shared neuronal tumour antigens. Affected patients often have one or more circulating antineuronal antibodies, which serve as a diagnostic marker for the paraneoplastic condition, and in some cases are the direct mediators of neuronal injury. The exact immunopathogenesis and relative contributions of humoral or cellular immune effectors for most paraneoplastic syndromes are not well understood. Some patients have a gratifying neurological response to tumour treatment and/or immunotherapy, especially if the diagnosis is made early and treatment is initiated promptly. Unfortunately, many patients are left with severe and permanent neurological deficits despite aggressive treatment. This review summarises the current understanding of the clinical immunology of paraneoplastic disorders, and outlines immunotherapy options and outcomes.

Animals↗

PubMed2004

Neurologic paraneoplastic syndromes.

Paraneoplastic disorders can affect any part of the central or peripheral nervous system. Although relatively uncommon, these disorders are a significant cause of severe neurologic disability among cancer patients. Many paraneoplastic disorders are believed to be caused by an autoimmune response directed against shared neural tumor antigens. This article summarizes the clinical features, possible autoimmune pathophysiology, and management issues for patients with paraneoplastic disorders.

Disease Management↗

PubMed2004

Neurotoxicity of cancer chemotherapy.

Neurological dysfunction is a common side effect of many chemotherapy drugs. For several agents neurotoxicity is common, severe, and can be dose-limiting. This is a review of the clinical features of chemotherapy-induced syndromes involving the central and peripheral nervous systems.

Cerebrovascular Disorders↗

PubMed2002

Remote neurologic manifestations of cancer.

Paraneoplastic disorders may affect any part of the central or peripheral nervous systems. Although relatively uncommon, these disorders are a significant cause of neurologic morbidity for cancer patients. At least some paraneoplastic syndromes are believed to be caused by an autoimmune reaction against shared tumor-neural antigens. This article summarizes the clinical features of paraneoplastic disorders, the current evidence for autoimmunity, and guidelines for diagnosis and treatment.

Autoantibodies↗