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Immunological and endocrinological abnormalities in paraneoplastic disorders with involvement of the autonomic nervous system

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Abstract

We report a series of four patients in whom the onset of systemic cancer was heralded by dysautonomic symptoms and a neurological non-metastatic complication mediated by immunological and endocrine factors. The series includes:

  • a patient with acute leukaemia and autonomic sensory-motor polyradiculoneuropathy,

  • a patient affected by colon carcinoma and autonomic neuropathy and limbic encephalitis,

  • a patient with lung cancer and autonomic neuropathy and hypercalcaemic encephalopathy,

  • a patient with small cell lung cancer associated with autonomic neuropathy in Lambert-Eaton Myasthenic Syndrome (LEMS) and syndrome of inappropriate ADH secretion (SIADH).

We underline the prognostic importance and discuss the possible etiopathogenetic role of autonomic dysfunction, which is frequently associated with paraneoplastic neurologic syndromes of autoimmune and/or dysendocrine origin.

Sommario

Descriviamo quattro casi con una sintomatologia d'esordio di una neoplasia sistemica caratterizzata da sintomi disautonomici ed una complicanza neurologica non metastatica a patogenesi autoimmune ed endocrina.

La serie include:

  • un paziente con leucemia acuta e poliradiculoneuropatia > autonomica e sensitivo-motoria,

  • un paziente con carcinoma del colon, neuropatia autonomica ed encefalite limbica,

  • un paziente con neoplasia polmonare, neuropatia autonomica ed encefalopatia ipercalcemica,

  • infine, un paziente con carcinoma a piccole cellule associato a neuropatia autonomica in sindrome miastenica di Lambert-Eaton (LEMS) e sindrome da inappropriata secrezione di ormone antidiuretico (SIADH).

Sottolineiamo l'importanza prognostica della disfunzione autonomica, frequentemente associata ad altre sindromi neurologiche paraneoplastiche, e ne discutiamo il possibile ruolo nelle concomitanti complicanze ad origine autoimmune e/o disendocrina.

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Authors and Affiliations

  1. Divisione di Neurologia, Ospedale Niguarda — Ca' Granda, Piazza Ospedale Maggiore, 3, 20162, Milano, Italy

    Riva M., Brioschi A. M., Marazzi R., Donato M. F. & Ferrante E.

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  1. Riva M.
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  2. Brioschi A. M.
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  3. Marazzi R.
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  4. Donato M. F.
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  5. Ferrante E.
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Riva, M., Brioschi, A.M., Marazzi, R. et al. Immunological and endocrinological abnormalities in paraneoplastic disorders with involvement of the autonomic nervous system. Ital J Neuro Sci 18, 157–161 (1997). https://doi.org/10.1007/BF02048484

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  • DOI: https://doi.org/10.1007/BF02048484

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