Paraneoplastic syndrome

Signs and symptoms of lung cancer can be classified into three subdivisions pulmonary, extrapulmonary, and paraneoplastic syndromes. Distinguishing between these classes of symptoms is important because it can aid in determining the severity of the disease, guide treatment options, and affect prognosis. 

Symptoms that are not a result of the direct effects of the tumor are termed paraneoplastic syndromes. They may be caused by substances secreted by the tumor or in response to the tumor and often occur in tissues far from the site of malignancy. Fhraneoplastic syndromes are numerous and affect a wide variety of systems, including the endocrine, neurologic, skeletal, renal, metabolic, vascular, and hematologic systems. 

Paraneoplastic syndromes are clinical syndromes owing to nonmetastatic systemic effects of cancer. Tumors make and secrete biologically active products that can stimulate or inhibit hormone production, autoimmunity, immune complex production, or immune suppression. Lung cancer, particularly small cell lung cancer, is associated with a high rate of paraneoplastic... 

Becldes MA, Spiro SG, Colice GL, et al. Initial evaluation of the patient with lung cancer Symptoms, signs, laboratory tests, and paraneoplastic syndromes. Chest 2003 123(1 suppl) 97S-104S. 

Intestinal pseudoobstruction is also part of paraneoplastic syndromes. The anti-/zu antibodies are useful to indicate this condition, as shown in bronchial small cell carcinoma [171], In pheochromocytoma [172] and carcinoid [173] neuromediators affecting small bowel motility are produced by the tumor cells. Intestinal pseudoobstruction has also been reported in neuroblastoma [174],... 

Paraneoplastic syndromes commonly associated with lung cancers include cachexia, hypercalcemia, syndrome of inappropriate antidiuretic hormone secretion, and Cushing s syndrome. 

All patients must have a thorough history and physical examination to detect signs and symptoms of the primary tumor, regional spread of the tumor, distant metastases, paraneoplastic syndromes, and ability to withstand aggressive surgery or chemotherapy. 

Stourac, R, Oligoclonal IgG synthesis in autoimmune neurological paraneoplastic syndromes. Clin. Biochem. Metab. 8(29), 224-228 (2000). 

Lennon VA, Kryzer TJ, Griesmann GE, O Suilleabhain PE, Windebank AJ, Woppmann A, Miljanich GP, Lambert EH (1995) Calcium-channel antibodies in the Lambert-Eaton syndrome and other paraneoplastic syndromes. N Engl J Med 332 1467-1474. 

Major Paraneoplastic Syndromes, Associated Antibodies, and Tumors... 

Posner JB. Paraneoplastic syndromes. Curr Opin Neurol 1997 10(6) 471—476. 

Anderson NE, Posner JB. Antineuronal autoantibodies in neurologic paraneoplastic syndromes. Ann NY Acad Sci 1988 540 440 141. 

Jacobs DA, Fung KM, Cook NM, Schalepfer WW, Goldberg HI, Stecker MM. Complex partial status epilepticus associated with anti-Hu paraneoplastic syndrome. J Neurol Sci 2003 213(1 2) 77 82. 

Bataller L, Dalmau J. Neuro-ophthalmology and paraneoplastic syndromes. Curr Opin Neurol 2004 17(l) 3-8. 

Nagashima T, Mizutani Y, Kawahara H, Maguchi S, Terayama Y, Shinohara T, et al. Anti-Hu paraneoplastic syndrome presenting with brainstem-cerebellar symptoms and Lambert-Eaton myasthenic syndrome. Neuropathology 2003 23(3) 230-238. 

Rudnicki SA, Dalmau J. Paraneoplastic syndromes of the spinal cord, nerve, and muscle. Muscle Nerve 2000 23(12) 1800-1818. 

Elrington GM, Murray NM, Spiro SG, Newsom-Davis J. Neurological paraneoplastic syndromes in patients with small cell lung cancer. A prospective survey of 150 patients. J Neurol Neurosurg Psychiatry 1991 54(9) 764-767. 

Darnell RB, Posner JB. Paraneoplastic syndromes involving the nervous system. N Engl J Med 2003 349(16) 1543-1554. 

Fumeaux HF, Reich L, Posner JB. Autoantibody synthesis in the central nervous system of patients with paraneoplastic syndromes. Neurology 1990 40(7) 1085-1091. 

Current opinions on cause and mechanism include the possibility that MS is often due to a form of molecular mimicry, in which an immune response to an infective or other exogenous agent leads to the formation of antibodies and/or cells that cross-react destructively with components of normal myelin. Molecular mimicry is well established in certain other disorders of the nervous system (Candler et al., 2006) including paraneoplastic syndromes (Posner, 2003). 

Porteus DJ, Thompson P, Brandon NJ, Millar JK (2006) The genetics and biology of DISC 1 - an emerging role in psychosis and cognition. Biol Psychiatry 60 123-131 Posner JB (2003 Sept) Immunology of paraneoplastic syndromes overview. Ann N Y Acad Sci 998 178-186... 

Hypertrichosis (particularly of the lanugo type) is also described as paraneoplastic syndrome, above all in cases of carcinoma of the intestinal tract or the digestive organs Herzberg-Potjan-Gebauer syndrome, 1969). 

Paraneoplastic syndrome Parasitic infections Parenteral nutrition Postoperative cholestasis Primary biliary cholangitis Primary sclerosing cholangitis Protoporphyria Right ventricular failure Sepsis... 

Polymyositis can occur as a primary disease or a paraneoplastic syndrome. Clinically, there is weakness and pain in the shoulder and hip musculature, with muscular atrophy. Laboratory parameters show greatly elevated inflammatory criteria (s. tab. 38.2) as well as a rise in myosin AB. Liver involvement is characterized by hepatomegaly, inflammatory infiltration of the portal fields, fatty changes in the liver cells and single-cell necrosis as well as necrotic foci. 

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