Anti-Hu antibody associated paraneoplastic neurological syndrome in a child with ganglioneuroblastoma: A rare case report and literature review

Medicine (Baltimore). 2024 May 10;103(19):e38148. doi: 10.1097/MD.0000000000038148.

Abstract

Rationale: Paraneoplastic neurological syndrome with anti-Hu antibody (Hu-PNS) is a neurological disorder that occur in patients with malignancy. The syndrome has a wide range of presentations and can present before diagnosis of primary malignancy. Familiarity with these paraneoplastic neurological syndromes can help early recognition and take appropriate regimens.

Patients concerns: Diagnosis and treatment of Hu-PNS.

Diagnoses: This is retrospective study that analyzed the clinical data of this case. Through retrospective analysis and targeted antibody screening, serum anti-Hu antibody was detected. Subsequent spinal imaging revealed a mass in the paraspinal region, which was confirmed as ganglioneuroblastoma by pathologic examination.

Interventions: The child was treated with a course of intravenous immunoglobulin and radical surgical operation without chemotherapy.

Outcomes: The neurological symptoms were gradually improved and no signs indicate disease progression or tumor recurrence.

Lessons: Hu-PNS has rarely been reported in children with ganglioneuroblastomas. They can mimic non-neoplastic processes, making detection and diagnosis difficult. Serum and/or cerebrospinal fluid onconeural antibody can strongly indicate occult cancers. Early detection of paraneoplastic neurological syndromes can help take appropriate regimens and improve prognosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Child, Preschool
  • ELAV Proteins / immunology
  • Ganglioneuroblastoma* / complications
  • Ganglioneuroblastoma* / immunology
  • Humans
  • Male
  • Paraneoplastic Syndromes, Nervous System* / diagnosis
  • Paraneoplastic Syndromes, Nervous System* / immunology
  • Retrospective Studies

Substances

  • ELAV Proteins
  • Autoantibodies