Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Limbic encephalitis is characterised by subacute development of short-term memory loss, seizures, confusion and psychiatric features.1 Paraneoplastic limbic encephalitis is generally associated with small cell lung cancer (SCLC), and around 50% of patients harbour Hu, CV2/CRMP5 or amphiphysin antibodies.1 Recently, antibodies against voltage-gated potassium channels (VGKC-abs) were identified as a new marker of a non-paraneoplastic, immunotherapy-responsive form of limbic encephalitis.2,3 However, the presence of VGKC-ab does not exclude a paraneoplastic cause of limbic encephalitis.1
We described previously a new antibody called anti-glial nuclear antibody (AGNA), a marker of SCLC shown to be closely associated with paraneoplastic Lambert–Eaton myasthenic syndrome (LEMS).4 Here we report on two patients with paraneoplastic limbic encephalitis associated with SCLC and VGKC-ab who also presented AGNA.
The presence of AGNA was assessed by immunohistochemistry on frozen sections of paraformaldehyde-fixed rat cerebellum in nine patients with limbic encephalitis and SCLC with (n = 2) or without (n = 7) VGKC-ab, and in seven patients with non-paraneoplastic limbic encephalitis and VGKC-ab. To confirm AGNA reactivity, an immunohistochemical competition assay was performed as described previously.4 VGKC-abs were detected by radioimmunoprecipitation (cutoff value: 100 pmol/l).2
A middle-aged man was admitted to hospital with a 2-week history of behavioural changes and generalised seizures. A neurological examination showed short-term memory loss, confusion and aphasia. Electroencephalography showed slowing in the left temporal lobe. Magnetic resonance …
Funding: L Z is a recipient of a fellowship grant of the European Neurological Society. This study was supported in part by grant PI030028 from the Fondo de Investigaciones Sanitarias, Madrid, Spain (to FG).
Competing interests: None.