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Anti-Ma and anti-Ta associated paraneoplastic neurological syndromes: Twenty-two newly diagnosed patients and review of previous cases
  1. L A Hoffmann (lisaann.hoffmann{at}med.uni-muenchen.de)
  1. Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany, Germany
    1. S Jarius (sven.jarius{at}med.uni-muenchen.de)
    1. Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany, Germany
      1. H L Pellkofer (hannah.pellkofer{at}med.uni-muenchen.de)
      1. Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany, Germany
        1. M Schüller (mschueller{at}web.de)
        1. Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany, Germany
          1. M Krumbholz (markus.krumbholz{at}med.uni-muenchen.de)
          1. Institute of Clinical Neuroimmunology, Ludwig-Maximilians-University, Munich, Germany, Germany
            1. F König (fkoenig{at}med.uni-goettingen.de)
            1. Institute of Neuropathology, University of Goettingen, Germany, Germany
              1. W Johannis (wibke.johannis{at}uk-koeln.de)
              1. Department of Laboratory Medicine, University Hospital, Cologne, Germany, Germany
                1. C La Fougere (cfougere{at}med.uni-muenchen.de)
                1. Department of Nuclear Medicine, Ludwigs-Maximilians-University, Munich, Germany, Germany
                  1. T Newman
                  1. Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, United K, United Kingdom
                    1. A Vincent (angela.vincent{at}imm.ox.ac.uk)
                    1. Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, United K, United Kingdom
                      1. R Voltz (raymond.voltz{at}uk-koeln.de)
                      1. Department of Palliative Medicine, University Hospital, Cologne, Germany, Germany

                        Abstract

                        Background: Paraneoplastic neurological syndromes (PNS) are indirect remote effects of cancer on the nervous system, often associated with the presence of specific serum antibodies. The most recently described PNS defining reactivity is anti-Ma/anti-Ta. Here we present 22 newly diagnosed patients with anti-Ma or anti-Ta reactivity, refine the associated clinical picture and review all published patients so far.

                        Patients and Methods: Patients were identified by testing for PNMA1 and PNMA2 antibodies by Western blotting and indirect immunoflurorecence. Clinical data were obtained either by referral of the patient, or from the referring physicians.

                        Results: Analysis of 22 new patients (14 anti-Ma, 8 anti-Ta ) confirms that anti-Ta are usually found in young men with limbic encephalitis and testicular germ cell tumours who stabilize neurologically with long term survival after tumour treatment. Patients with anti-Ma are of either sex, middle-aged, present with a range of tumours and neurological symptoms and a limited response to treatment. Futhermore, we expand the range of associated clinical features: (1) The peripheral nervous system may be involved. (2) An overlap with anti-Hu is possible. (3) Testicular tumour manifestation can be extragonadal or detectable only at orchiectomy.

                        Conclusion: Refining and expanding the range of anti-Ma/anti-Ta associated neurological presentations and tumours clearly demonstrate that the distinction between anti-Ma and anti-Ta associated paraneoplastic neurological syndromes is of high clinical relevance.

                        • Ma1 antigen
                        • Ma2 antigen
                        • limbic encephalitis
                        • paraneoplastic syndromes, nervous system
                        • testicular neoplasia

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