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These disorders may develop anytime during the course of the neoplastic disease. Serum and urine immunofixation studies should be considered in pts with peripheral neuropathy of unknown cause; detection of a monoclonal gammopathy suggests the need for additional studies to uncover a B cell or plasma cell malignancy. In paraneoplastic neuropathies, diagnostically useful antineuronal antibodies are limited to anti-CV2/CRMP5 and anti-Hu.

Myasthenia gravis is discussed in Chap. 194. Myasthenia Gravis and dermatomyositis in Chap. 195. Muscle Diseases.

Treatment: Paraneoplastic Neurologic Disorders

  • Treatment of PNDs focuses mainly on recognition and control of the underlying malignancy; a stabilization or improvement of symptoms has been reported in some pts with successful tumor control.
  • Variable responses have been described following treatment with glucocorticoids and other immunosuppressive agents as well as intravenous immunoglobulin (IVIg) and plasma exchange.
  • Those PNDs caused by antibodies to cell surface or synaptic antigens have a much more favorable response to therapy.

For a more detailed discussion, see Dalmau J, Rosenfeld MR: Paraneoplastic Neurologic Syndromes and Autoimmune Encephalitis, Chap. 122, p. 614, in HPIM-19.

Outline

Section 6. Hematology and Oncology