Paraneoplastic Antibodies
Common Paraneoplastic Antibodies
Anti-Hu (ANNA-1)
Small cell lung cancer
- Limbic encephalitis
- Rapid onset neuro-behavioral/cognitive decline
- Sensory neuropathy/neuronopathy
- Asymmetric, rapidly progressive loss of sensation of the limbs with profound loss of proprioception, secondary to an attack at the dorsal root ganglion.
- Opsoclonus myoclonus in children with neuroblastoma may be associated with anti-Hu antibodies.
Anti-Ri (ANNA-2) antibody
Breast cancer (commonly)
- Opsoclonus myoclonus
- Opsoclonus, myoclonus, and ataxia
- Note that neuroblastoma is a key cause of opsoclonus-myoclonus in children; these children typically do NOT have anti-Ri antibodies but rather may have anti-Hu antibodies.
Anti-amphiphysin antibody
- Stiff-person syndrome
- Periodic muscle rigidity/stiffness of the limbs and trunk
- Note that the non-paraneoplastic antibody cause is anti-GAD65 antibody
Anti-voltage-gated P/Q type calcium channel antibodies in association w/AGNA (SOX1)
Small cell lung cancer
- Lambert-Eaton myasthenic syndrome
- Subactue, progressive weakness of the shoulders, feet/hands, and oropharynx, followed by the eyes, secondary to a neuromuscle junction attack (like myasthenia gravis).
Anti-Yo antibody
Ovarian cancer, classically. Breast cancer, commonly.
- Paraneoplastic cerebellar degeneration
- Rapidly progressive (days to weeks) cerebellar (gait, balance, coordination) disorder
Anti-Ma (Anti-Ma-1)
Lung, testicular, and breast cancers
- Cerebellar syndrome
Anti-Ta (Anti-Ma-2)
Testicular (or extragonadal) germ cell tumor
- Limbic encephalitis
- More common in males than females
Anti-recoverin antibody (aka, anti-CAR (cancer-associated retinopathy)
- Paraneoplastic retinal degeneration
- Painless, progressive degeneration of peripheral vision (later central vision), secondary to antibody attack of retinal bipolar cell antigens
- also associated with anti-MAR (melanoma associated retinopathy)
Anti-CRMP-5/CV2 antibody
Small cell lung cancer (commonly)
- Peripheral neuropathies, encephalomyelitis, optic neuritis, limbic encephalitis, etc...
- Paraneoplastic choreoathetosis (aka, basal ganglionitis)
- Choreoathetosis is the prominent symptom, parkinsonism and hemiballismus have also been reported.