PT  - JOURNAL ARTICLE
AU  - Honnorat, J
AU  - Cartalat-Carel, S
AU  - Ricard, D
AU  - Camdessanche, J Ph
AU  - Carpentier, A F
AU  - Rogemond, V
AU  - Chapuis, F
AU  - Aguera, M
AU  - Decullier, E
AU  - Duchemin, A M
AU  - Graus, F
AU  - Antoine, J C
TI  - Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies
AID  - 10.1136/jnnp.2007.138016
DP  - 2009 Apr 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 412--416
VI  - 80
IP  - 4
4099  - http://jnnp.bmj.com/content/80/4/412.short
4100  - http://jnnp.bmj.com/content/80/4/412.full
SO  - J Neurol Neurosurg Psychiatry2009 Apr 01; 80
AB  - Objective: Anti-Hu antibodies (Hu-Ab) and anti-CV2/CRMP5 antibodies (CV2/CRMP5-Ab) have been identified in association with paraneoplastic neurological disorders. However, it is not clear whether these antibodies are associated with specific neurological symptoms or are only markers of anti-cancer immune reaction.Methods: To address this question, 37 patients with CV2/CRMP5-Ab and 324 patients with Hu-Ab were compared.Results: Whereas the age and sex ratio were the same between the two groups, the distribution of neurological symptoms was not. Patients with CV2/CRMP5-Ab presented more frequently cerebellar ataxia, chorea, uveo/retinal symptoms and myasthenic syndrome (Lambert–Eaton myasthenic syndrome LEMS or myasthenia gravis). They also had a better Rankin score. In contrast, dysautonomia, brainstem encephalitis and peripheral neuropathy were more frequent in patients with Hu-Ab. Limbic encephalitis occurred similarly in both groups. Small-cell lung cancer was the most frequently associated tumour in both groups of patients, while malignant thymoma was observed only in patients with CV2/CRMP5-Ab. In particular, patients with CV2/CRMP5-Ab and thymoma developed myasthenic syndrome more frequently, while patients with SCLC developed neuropathies more frequently. Chorea and myasthenic syndrome were only seen in patients with CV2/CRMP5-Ab. The median survival time was significantly longer in patients with CV2/CRMP5-Ab, and this effect was not dependent on the type of tumour.Interpretation: The data demonstrate that in patients with paraneoplastic neurological syndromes, the neurological symptoms and survival vary with both the type of associated onco-neural antibody and the type of tumour.