Neuroimmunology of OMS and ANNA-1/anti-Hu paraneoplastic syndromes in a child with neuroblastoma.

Abstract

Paraneoplastic neurologic disorders have been at the frontier of neuroimmunology for decades and remain urgent. Newer tools for the diagnosis and treatment of neuroinflammation include autoantibody screening, lymphocyte subset analysis, oligoclonal bands, and profiling of chemokines/cytokines and brain-related proteins in CSF and blood/serum. Opsoclonus-myoclonus syndrome (OMS), a paraneoplastic disorder without a known diagnostic antibody marker, is associated with remote neuroblastoma and is often relapsing.1 Paraneoplastic encephalomyelitis with type 1 antineuronal nuclear antibodies (ANNA-1) (alias anti-Hu)2 also may occur in children with neuroblastoma3–5 and exhibits intrathecal B- and T-cell inflammation in adults.6 We now provide a detailed neuroimmunologic profile of a child with both relapsing OMS and ANNA-1 paraneoplastic syndromes and neuroblastoma. Acknowledgment: Dr. Pranzatelli is a clinician-scientist; President and Founder of the National Pediatric Neuroinflammation Organization, Inc.; and an Adjoint Professor of Neurology at the University of Colorado School of Medicine. The National Pediatric Myoclonus Center relocated from Springfield, IL (SIU School of Medicine) to Orlando, FL, in 2014 to become the current independent, nonprofit organization. The authors thank Elizbeth D. Tate, MN, ARNP, C-FNP, who participated in clinical care, the patient, her family, and referring and treating physicians.