Abstract
Paraneoplastic manifestations are frequently seen in patients with small cell lung carcinoma (SCLC) and can present as diverse clinical entities ranging from endocrinopathies to neurological conditions. Anti-Hu encephalitis is a rare paraneoplastic manifestation most commonly seen in patients with SCLC. This case highlights an SCLC patient who presented with behavioral changes, cognitive deficits, and memory issues, and was found to have anti-Hu encephalitis. The subacute course of this clinical entity should be kept in mind and prompt further investigation in SCLC patients with these symptoms, especially when the laboratory workup of the major culprits is negative or inconclusive.
Highlights
Small cell lung carcinoma (SCLC) is a subtype of lung cancer occurring almost exclusively in patients with smoking history
Its incidence compared to other subtypes of lung carcinoma has been steadily decreasing with the latest data from the Surveillance, Epidemiology, and End Results (SEER) indicating that SCLC comprises 13% of all lung cancers [1]
SCLC is frequently categorized as a primary lung malignancy of neuroendocrine origin along with the large cell neuroendocrine carcinoma and the carcinoid tumors of the lung, which appear to share a common genomic and proteomic profile [2,3,4]
Summary
Small cell lung carcinoma (SCLC) is a subtype of lung cancer occurring almost exclusively in patients with smoking history. The patient had a history of alcohol abuse; she reported that she had not used alcohol for the past six months She was diagnosed with SCLC approximately a year prior to this presentation and had completed chemotherapy regimen with carboplatin and etoposide. The panel demonstrated significantly elevated titers of the ANNA-1 (titer of 1:1,920) in the cerebrospinal fluid, which is known as anti-Hu. In patients with SCLC, this is consistent with paraneoplastic encephalitis associated with anti-Hu. The clinical manifestations of behavioral changes, memory issues, and new-onset seizures, along with the MRI findings and the treatment response with corticosteroids and intravenous immunoglobulin, further support the diagnosis
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