@article {Shahe632作者= {Shailee沙和Rocio巴斯克斯Campo Neeraj Kumar说,安德鲁·麦肯和Eoin p·弗拉纳根和克里斯托弗·克莱因和肖恩·j·Pittock Divyanshu Dubey}, title ={多种Myeloneuropathies},体积={96}={4},页面= {e632——e639} = {2021}, doi = {10.1212 / WNL。出版商0000000000011218}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={客观测试假设myeloneuropathy呈现表型的多种神经系统症状我们回顾了首页临床,放射,患者和32的血清学的特征伴随多种的脊髓和周围神经系统的参与。方法观察研究调查myeloneuropathy和潜在癌症患者或onconeural抗体血清阳性。结果32患者多种myeloneuropathy 20(63 \ %)是女性平均年龄61岁(范围{\ textendash} 84年27日)。26例(81 \ %)分类onconeural抗体(amphiphysin n = 8;antineuronal核抗体(安娜)1型(anti-Hu), n = 5;collapsin响应中介蛋白5 [CRMP5] [anti-CV2], n = 6;浦肯野细胞胞质抗体1型[PCA1] [anti-Yo], n = 1;浦肯野细胞胞质抗体2型(PCA2), n = 2;kelch-like蛋白11 [KLHL11], n = 1;及其组合:ANNA1 / CRMP5, n = 1; ANNA1/amphiphysin, n = 1; ANNA3/CRMP5, n = 1). Cancer was confirmed in 25 cases (onconeural antibodies, n = 19; unclassified antibodies, n = 3; no antibodies, n = 3). Paraneoplastic myeloneuropathies had asymmetric paresthesias (84\%), neuropathic pain (78\%), subacute onset (72\%), sensory ataxia (69\%), bladder dysfunction (69\%), and unintentional weight loss \>15 pounds (63\%). Neurologic examination demonstrated concomitant distal or asymmetric hyporeflexia and hyperreflexia (81\%), impaired vibration and proprioception (69\%), Babinski response (68\%), and asymmetric weakness (66\%). MRI showed longitudinally extensive (45\%), tract-specific spinal cord T2 hyperintensities (39\%) and lumbar nerve root enhancement (38\%). Ten of 28 (36\%) were unable to ambulate independently at last follow-up (median 24 months, range 5{\textendash}133 months). Combined oncologic and immunologic therapy had more favorable modified Rankin Scale scores at post-treatment follow-up compared to those receiving either oncologic or immunologic therapy alone (2 [range 1{\textendash}4] vs 4 [range 2{\textendash}6], p \< 0.001).Conclusions Paraneoplastic etiologies should be considered in the evaluation of subacute myeloneuropathies. Recognition of key characteristics of paraneoplastic myeloneuropathy may facilitate early tumor diagnosis and initiation of immunosuppressive treatment.ANNA=antineuronal nuclear antibody; CRMP5=collapsin response mediator protein 5; IgG=immunoglobulin G; KLHL11=kelch-like protein s11; MAP1B=microtubule-associated protein 1B antibody; mRS=modified Rankin Scale; PCA=Purkinje cell cytoplasmic antibody}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/96/4/e632}, eprint = {//www.ez-admanager.com/content/96/4/e632.full.pdf}, journal = {Neurology} }
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