文摘
摘要目的:描述周围神经病变患者的组织病理学与多种神经综合症(pn)支持的自体抗体测试。
背景:罕见的尸检病例pn建议协会共同抗原的误导细胞毒性t细胞对癌症和神经组织。神经病变可能是第一个表现但周围神经病理学的报道是有限的。我们试图回顾病理发现在神经活检的患者有神经病变导致癌症和高风险的多种抗体血清阳性。
设计/方法:我们回顾了患者的临床数据和神经活检报告与神经病变和多种症状回顾他们的癌症诊断和外围发作。
结果:十二腓肠神经和桡神经活检,从一个患者抗体:Amphiphysin (n = 6);Antineuronal核抗体(安娜)1 (n = 2);ANNA-2 (n = 2);Collapsin响应中介protein-5 (CRMP-5) (n = 2);和浦肯野细胞浆抗体(PCA1) (n = 1)。抗体检测通常发生在活组织检查或并发,所有患者亚急性发作。患者重叠责任人:length-dependent神经病变(n = 5),颅神经病变(n = 1),臂plexopathy (n = 1),多个单神经病(n = 2),和腰骶radiculoplexus参与(n = 8)。诊断时间延长;通常一年以后。恶性肿瘤是多样化包括乳腺癌、卵巢癌、膀胱癌、非小细胞肺癌,小细胞肺癌,结肠癌和乳腺癌共存。 Fiber density was reduced in all, with multifocality frequently seen. Perineurial injury was absent, but sub-perineurial edema was common (n=4). Significant inflammation was absent in all but 5 cases, where small to moderate-sized CD45 collections were seen with vessel wall involvement with clinical lumbosacral plexus neuropathy (Amphiphysin (n=2), ANNA-2, and CRMP5) or multiple mononeuropathies (PCA-1).
结论:没有减少的炎性浸润,纤维密度远端感觉神经活检在多种神经病变是常见的。一个近端炎症过程的理论。也会发生微脉管炎性浸润血管壁参与尤其是腰骶plexopathy表型。
披露:格兰杰医生没有披露。Rajnauth博士没有披露。Dubey博士的机构已收到个人薪酬在500 - 4999美元的范围作为顾问的联合。Dubey博士的机构已收到个人薪酬在5000 - 9999美元的范围作为顾问阿斯特拉。机构Dubey博士已收到个人薪酬在500 - 4999美元的范围为Argenx担任顾问。Dubey博士已经收到个人补偿的范围为0 - 499美元在愁云密布的演讲人。Dubey博士已经收到个人补偿的范围为0 - 499美元在神经学的进步的演讲人。首页Dubey博士已经收到个人补偿的范围0 - 499美元为服务Moffit所癌症中心的演讲人。Dubey博士已经收到了来自国防部的研究支持。Dubey博士已经收到知识产权利益从发现或技术有关卫生保健。 Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Mills has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Mauermann has received research support from IONIS. The institution of Dr. Mauermann has received research support from Alnylam. Dr. Mauermann has received publishing royalties from a publication relating to health care. Dr. Berini has nothing to disclose. Dr. Dyck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Akcea/Ionis. Dr. Klein has a non-compensated relationship as a Klein with Neurology Journal that is relevant to AAN interests or activities.
