Abstract
A 60-year-old man presented with vitritis and optic neuropathy in the setting of headaches and behavioral changes. MRI brain revealed bilateral temporal lobe inflammation consistent with limbic encephalitis. He was subsequently diagnosed with small cell lung cancer with a paraneoplastic syndrome characterized by CRMP5 IgG as a cause of his symptoms. His visual symptoms improved markedly after anti-inflammatory therapy and his cognitive symptoms were mildly better following systemic chemotherapy. The clinical presentation, pathophysiology, and therapy of CRMP5 associated paraneoplastic syndromes are discussed.
Copyright 2010 Elsevier Inc. All rights reserved.
MeSH terms
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Antineoplastic Agents / therapeutic use
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Cognition Disorders / diagnosis
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Electroencephalography
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Eye Diseases / diagnosis*
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Glucocorticoids / therapeutic use
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Humans
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Hydrolases
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Immunoglobulin G / blood
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Lung Neoplasms / diagnosis*
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Lung Neoplasms / drug therapy
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Lung Neoplasms / immunology
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Magnetic Resonance Imaging
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Male
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Microtubule-Associated Proteins
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Middle Aged
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Nerve Tissue Proteins / immunology
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Optic Nerve Diseases / diagnosis*
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Paraneoplastic Syndromes / diagnosis*
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Paraneoplastic Syndromes / drug therapy
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Paraneoplastic Syndromes / immunology
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Small Cell Lung Carcinoma / diagnosis*
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Small Cell Lung Carcinoma / drug therapy
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Small Cell Lung Carcinoma / immunology
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Tomography, X-Ray Computed
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Vitreous Body / pathology*
Substances
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Antineoplastic Agents
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Glucocorticoids
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Immunoglobulin G
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Microtubule-Associated Proteins
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Nerve Tissue Proteins
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DPYSL5 protein, human
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Hydrolases