An Elderly Case of Paraneoplastic Anti-NMDA Receptor Encephalitis Associated with Small-cell Lung Cancer Expressing NR1 Subunits
A 61-year-old Japanese man presented with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. NR1 antibodies were detected in his cerebrospinal fluid. Chest computed tomography revealed lung tumor. The patient was diagnosed with paraneoplastic anti-NMDAR encephalitis associated with lung cancer...
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| Veröffentlicht in: | Internal Medicine 2020/09/15, Vol.59(18), pp.2307-2309 |
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| creator | Kobayashi, Yuya Sato, Mitsuto Kinoshita, Michiaki Kakizawa, Masaki Higuchi, Kayoko Yamada, Mitsunori Kodaira, Minori Sekijima, Yoshiki |
| description | A 61-year-old Japanese man presented with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. NR1 antibodies were detected in his cerebrospinal fluid. Chest computed tomography revealed lung tumor. The patient was diagnosed with paraneoplastic anti-NMDAR encephalitis associated with lung cancer and treated with two cycles of intravenous high-dose methylprednisolone and one cycle of intravenous immunoglobulin. However, he died one year later without improvement. An autopsy confirmed small-cell lung cancer (SCLC). Immunohistochemistry revealed the expression of NR1 subunits in the tumor cells, suggesting that SCLC may trigger NR1 autoimmunity though the expression of NR1 subunits as onconeural antigens, expanding the phenotypic spectrum of paraneoplastic neurological syndrome associated with SCLC. |
| doi_str_mv | 10.2169/internalmedicine.4860-20 |
| format | Article |
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NR1 antibodies were detected in his cerebrospinal fluid. Chest computed tomography revealed lung tumor. The patient was diagnosed with paraneoplastic anti-NMDAR encephalitis associated with lung cancer and treated with two cycles of intravenous high-dose methylprednisolone and one cycle of intravenous immunoglobulin. However, he died one year later without improvement. An autopsy confirmed small-cell lung cancer (SCLC). Immunohistochemistry revealed the expression of NR1 subunits in the tumor cells, suggesting that SCLC may trigger NR1 autoimmunity though the expression of NR1 subunits as onconeural antigens, expanding the phenotypic spectrum of paraneoplastic neurological syndrome associated with SCLC.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.4860-20</identifier><identifier>PMID: 32493856</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>anti-N-methyl-D-aspartate receptor ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis ; Antibodies - therapeutic use ; Antigens ; Autoantibodies ; Autoimmunity ; Autopsy ; Case Report ; Cerebrospinal fluid ; Computed tomography ; Encephalitis ; Glutamic acid receptors ; Glutamic acid receptors (ionotropic) ; Humans ; Immunoglobulins - therapeutic use ; Immunoglobulins, Intravenous - therapeutic use ; Immunohistochemistry ; Internal medicine ; Intravenous administration ; Lung cancer ; Lung Neoplasms - complications ; Lung Neoplasms - drug therapy ; Male ; Methylprednisolone ; Methylprednisolone - therapeutic use ; Middle Aged ; N-Methyl-D-aspartic acid receptors ; NMDAR ; paraneoplastic syndrome ; Receptors, N-Methyl-D-Aspartate - immunology ; SCLC ; small cell lung cancer ; Small cell lung carcinoma ; Small Cell Lung Carcinoma - complications ; Small Cell Lung Carcinoma - drug therapy ; Tumor cells</subject><ispartof>Internal Medicine, 2020/09/15, Vol.59(18), pp.2307-2309</ispartof><rights>2020 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2020</rights><rights>Copyright © 2020 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-1daea7f00cb2fc153e1a5cd8503d0cf74aa55fcc60475936e321cb0e5cb44daa3</citedby><cites>FETCH-LOGICAL-c610t-1daea7f00cb2fc153e1a5cd8503d0cf74aa55fcc60475936e321cb0e5cb44daa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578603/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578603/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1883,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32493856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kobayashi, Yuya</creatorcontrib><creatorcontrib>Sato, Mitsuto</creatorcontrib><creatorcontrib>Kinoshita, Michiaki</creatorcontrib><creatorcontrib>Kakizawa, Masaki</creatorcontrib><creatorcontrib>Higuchi, Kayoko</creatorcontrib><creatorcontrib>Yamada, Mitsunori</creatorcontrib><creatorcontrib>Kodaira, Minori</creatorcontrib><creatorcontrib>Sekijima, Yoshiki</creatorcontrib><title>An Elderly Case of Paraneoplastic Anti-NMDA Receptor Encephalitis Associated with Small-cell Lung Cancer Expressing NR1 Subunits</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 61-year-old Japanese man presented with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. NR1 antibodies were detected in his cerebrospinal fluid. Chest computed tomography revealed lung tumor. The patient was diagnosed with paraneoplastic anti-NMDAR encephalitis associated with lung cancer and treated with two cycles of intravenous high-dose methylprednisolone and one cycle of intravenous immunoglobulin. However, he died one year later without improvement. An autopsy confirmed small-cell lung cancer (SCLC). Immunohistochemistry revealed the expression of NR1 subunits in the tumor cells, suggesting that SCLC may trigger NR1 autoimmunity though the expression of NR1 subunits as onconeural antigens, expanding the phenotypic spectrum of paraneoplastic neurological syndrome associated with SCLC.</description><subject>anti-N-methyl-D-aspartate receptor</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis</subject><subject>Antibodies - therapeutic use</subject><subject>Antigens</subject><subject>Autoantibodies</subject><subject>Autoimmunity</subject><subject>Autopsy</subject><subject>Case Report</subject><subject>Cerebrospinal fluid</subject><subject>Computed tomography</subject><subject>Encephalitis</subject><subject>Glutamic acid receptors</subject><subject>Glutamic acid receptors (ionotropic)</subject><subject>Humans</subject><subject>Immunoglobulins - therapeutic use</subject><subject>Immunoglobulins, Intravenous - therapeutic use</subject><subject>Immunohistochemistry</subject><subject>Internal medicine</subject><subject>Intravenous administration</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - complications</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Male</subject><subject>Methylprednisolone</subject><subject>Methylprednisolone - therapeutic use</subject><subject>Middle Aged</subject><subject>N-Methyl-D-aspartic acid receptors</subject><subject>NMDAR</subject><subject>paraneoplastic syndrome</subject><subject>Receptors, N-Methyl-D-Aspartate - immunology</subject><subject>SCLC</subject><subject>small cell lung cancer</subject><subject>Small cell lung carcinoma</subject><subject>Small Cell Lung Carcinoma - complications</subject><subject>Small Cell Lung Carcinoma - drug therapy</subject><subject>Tumor cells</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkVFv0zAUhSMEYt3gLyBLvPCSYcdxEr8gVV0ZSGVDGzxbt85N68p1gu0Ae-On46ilgvFybdnfPfY9J8sIo5cFq-Rb4yJ6B3aPrdHG4WXZVDQv6JNsxngp87rg4mk2o5I1eZHKWXYewo5S3tSyeJ6d8aKUvBHVLPs1d2RpW_T2gSwgIOk78hk8OOwHCyEaTeYumvzm09Wc3KHGIfaeLF3abMGaaAKZh9BrAxFb8sPELbnfg7W5RmvJanSbJJvo1PNz8BiCSSc3d4zcj-vRmRheZM86sAFfHteL7Ov75ZfFh3x1e_1xMV_lumI05qwFhLqjVK-LTjPBkYHQbSMob6nu6hJAiE7ripa1kLxCXjC9pij0uixbAH6RvTvoDuM62abRRQ9WDd7swT-oHoz698aZrdr031Ut6mQuTwJvjgK-_zZiiGpvwjTl5NUYVFFSWXFJ6zKhrx-hu36c8pqospaVkFWVqOZAad-H4LE7fYZRNcWsHsespphVQVPrq7-HOTX-yTUBtwdgFyJs8ASAT4la_F9ZSMWaqR6fOJF6C16h478BWE7IxQ</recordid><startdate>20200915</startdate><enddate>20200915</enddate><creator>Kobayashi, Yuya</creator><creator>Sato, Mitsuto</creator><creator>Kinoshita, Michiaki</creator><creator>Kakizawa, Masaki</creator><creator>Higuchi, Kayoko</creator><creator>Yamada, Mitsunori</creator><creator>Kodaira, Minori</creator><creator>Sekijima, Yoshiki</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200915</creationdate><title>An Elderly Case of Paraneoplastic Anti-NMDA Receptor Encephalitis Associated with Small-cell Lung Cancer Expressing NR1 Subunits</title><author>Kobayashi, Yuya ; 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Med.</addtitle><date>2020-09-15</date><risdate>2020</risdate><volume>59</volume><issue>18</issue><spage>2307</spage><epage>2309</epage><pages>2307-2309</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>A 61-year-old Japanese man presented with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. NR1 antibodies were detected in his cerebrospinal fluid. Chest computed tomography revealed lung tumor. The patient was diagnosed with paraneoplastic anti-NMDAR encephalitis associated with lung cancer and treated with two cycles of intravenous high-dose methylprednisolone and one cycle of intravenous immunoglobulin. However, he died one year later without improvement. An autopsy confirmed small-cell lung cancer (SCLC). Immunohistochemistry revealed the expression of NR1 subunits in the tumor cells, suggesting that SCLC may trigger NR1 autoimmunity though the expression of NR1 subunits as onconeural antigens, expanding the phenotypic spectrum of paraneoplastic neurological syndrome associated with SCLC.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>32493856</pmid><doi>10.2169/internalmedicine.4860-20</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Internal Medicine, 2020/09/15, Vol.59(18), pp.2307-2309 |
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| subjects | anti-N-methyl-D-aspartate receptor Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis Antibodies - therapeutic use Antigens Autoantibodies Autoimmunity Autopsy Case Report Cerebrospinal fluid Computed tomography Encephalitis Glutamic acid receptors Glutamic acid receptors (ionotropic) Humans Immunoglobulins - therapeutic use Immunoglobulins, Intravenous - therapeutic use Immunohistochemistry Internal medicine Intravenous administration Lung cancer Lung Neoplasms - complications Lung Neoplasms - drug therapy Male Methylprednisolone Methylprednisolone - therapeutic use Middle Aged N-Methyl-D-aspartic acid receptors NMDAR paraneoplastic syndrome Receptors, N-Methyl-D-Aspartate - immunology SCLC small cell lung cancer Small cell lung carcinoma Small Cell Lung Carcinoma - complications Small Cell Lung Carcinoma - drug therapy Tumor cells |
| title | An Elderly Case of Paraneoplastic Anti-NMDA Receptor Encephalitis Associated with Small-cell Lung Cancer Expressing NR1 Subunits |
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