Anti-Hu paraneoplastic brainstem encephalitis caused by a pancreatic neuroendocrine tumor presenting with central hypoventilation

J Clin Neurosci. 2017 Jun:40:72-73. doi: 10.1016/j.jocn.2017.02.015. Epub 2017 Feb 27.

Abstract

Paraneoplastic neurological syndromes are rare autoimmune manifestations of malignancies associated with specific antibodies. Anti-Hu associated brainstem encephalitis, a well-described syndrome, usually presents subacutely with preferential involvement of the medulla. Anti-Hu antibodies target intraneuronal antigens and are therefore highly correlated with neurological syndromes when present concomitantly with a neoplasm. Reported is a case of anti-Hu brainstem encephalitis associated with a pancreatic neuroendocrine tumor (PNET) presenting with central hypoventilation. This is the first described case of brainstem encephalitis associated with a well-differentiated PNET as well as the first case of Anti-Hu antibodies associated with a PNET. There are no standardized protocols for the treatment of paraneoplastic brainstem encephalitis however, as in the present case, surgical resection and oncological treatment of the tumor is the first line treatment.

Keywords: Brainstem encephalitis; Pancreatic neuroendocrine tumor; Paraneoplastic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Encephalitis / diagnosis*
  • Encephalitis / etiology
  • Humans
  • Hypoventilation / diagnosis*
  • Hypoventilation / etiology
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / complications
  • Neuroendocrine Tumors / pathology*
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / pathology*
  • Paraneoplastic Syndromes, Nervous System / diagnosis*
  • Paraneoplastic Syndromes, Nervous System / etiology