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Anti-NMDAR-Positive Small-Cell Lung Cancer Paraneoplastic Limbic Encephalitis: A Case Report and Literature Review.

التفاصيل البيبلوغرافية
العنوان: Anti-NMDAR-Positive Small-Cell Lung Cancer Paraneoplastic Limbic Encephalitis: A Case Report and Literature Review.
المؤلفون: Sohal R; Department of Medicine, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Adams SH; Department of Pathology, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Phogat V; Department of Medicine, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Harish A; Department of Medicine, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Lopez CYD; Department of Neurology, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Williams MPA; Department of Pathology, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Khurana KK; Department of Pathology, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Abuzuaiter B; Department of Medicine, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Jagroop N; Department of Medicine, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA., Narapureddy B; Department of Neurology, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA.
المصدر: Case reports in neurological medicine [Case Rep Neurol Med] 2020 Jun 02; Vol. 2020, pp. 5269352. Date of Electronic Publication: 2020 Jun 02 (Print Publication: 2020).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Hindawi Pub. Corp Country of Publication: United States NLM ID: 101576451 Publication Model: eCollection Cited Medium: Print ISSN: 2090-6668 (Print) Linking ISSN: 20906676 NLM ISO Abbreviation: Case Rep Neurol Med Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Hindawi Pub. Corp.
مستخلص: Introduction: Paraneoplastic limbic encephalitis (PLE) is a rare disease that presents as rapid onset dementia characterized by short-term memory loss (STM), anxiety, and behavioral changes. Anti-NMDAR antibodies are unfrequently reported in PLE associated with small-cell lung cancer (SCLC). Given that PLE can precede the diagnosis of cancer, it is very important that once infectious, metabolic, nutritional, or structural disorders associated with short-term memory loss are ruled out that vigorous effort must be made to rule out underlying malignancy.
Case: We report a rare case of PLE as the presenting symptom of SCLC. A 72-year-old male with history of COPD was brought to the ED by his wife after he was found to have short-term memory loss, including forgetfulness of his wedding anniversary the day before, and anxiety. Neurological exam showed impaired short-term recall on MOCA. CT head showed no evidence of infarct. Lumbar puncture was performed which showed lymphocytic pleocytosis, a nonspecific inflammatory change. CSF panel was negative for HSV, Neisseria , Hemophilus , E. coli , and HIV. Initial EEG was unremarkable, though a repeat EEG showed mild slowing of the posterior dominant rhythm consistent with mild encephalopathy. MRI showed equivocal increased FLAIR on T2-weighted images in the bilateral temporal lobes, left greater than right. CTA thorax showed bulky mediastinal and right hilar LAD. FNA of the R4 lymph node revealed SCLC. The NM bone scan showed no osteoblastic lesions. While the serum autoantibody panel was positive for anti-NMDAR, the CSF autoantibody panel returned entirely negative. Chemotherapy with etoposide and cisplatin was started on Day 4 of admission. The patient's neurological symptoms showed improvement following chemotherapy.
Conclusion: This case highlights the importance of recognizing short-term memory loss as a feature of PLE.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2020 Raman Sohal et al.)
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تواريخ الأحداث: Date Created: 20200623 Latest Revision: 20220415
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC7288224
DOI: 10.1155/2020/5269352
PMID: 32566334
قاعدة البيانات: MEDLINE
الوصف
تدمد:2090-6668
DOI:10.1155/2020/5269352