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Article Dans Une Revue Journal of Neurology Année : 2018

Malignant tumors in autoimmune encephalitis with anti-NMDA receptor antibodies

Eve Chanson
  • Fonction : Auteur
Géraldine Picard
  • Fonction : Auteur
David Meyronet
Marie-Eve Mayeur
  • Fonction : Auteur
François Ducray
Veronique Rogemond
  • Fonction : Auteur
Dimitri Psimaras
  • Fonction : Auteur
Jean-Christophe Antoine
Jean-Yves Delattre
  • Fonction : Auteur
Virginie Desestret
  • Fonction : Auteur
Jerome Honnorat

Résumé

Objective: The aim of this study was to describe specificities of patients with NMDA receptor antibody (NMDAR-Ab) encephalitis associated with a malignant tumor. Methods: Retrospective observational study of 252 patients with NMDAR-Ab encephalitis of the French Paraneoplastic Neurological Syndrome Reference Center. Patients were classified in three groups: (1) non-malignant ovarian teratomas, (2) malignant ovarian teratomas (immature), and (3) other malignant tumors. Results: Sixty patients (23.8%) had an associated tumor and 15 (6%) were malignant. No particular neurological symptom was observed in these patients. Ovarian teratomas were the most frequent (51 cases) with 6 of them immature (11.8% of teratomas). Nine patients (3.6%) developed other malignant tumors (3 small cell lung carcinomas, 1 uterine adenocarcinoma, 1 prostate adenocarcinoma, 1 Hodgkin lymphoma, 1 pineal dysgerminoma, 1 neuroblastoma and 1 pancreatic neuroendocrine tumor). Among patients with a cancer other than teratoma, 6/9 were elderly patients (median age 65 years, representing 30% of elderly patients with such encephalitis) compared to a median age of 26 years in adult patients included herein. The clinical course was similar in the three groups, other than a higher death rate among patients with malignant tumors (86 versus 2%; p < 0.001) mainly due to tumor progression (5/7 deaths). Conclusion: Immature ovarian teratomas represent 11.8% of all teratomas in patients with NDMAR-Ab encephalitis. The other malignant tumors are mainly observed in elderly patients. The presence of a malignant tumor does not impact the neurological presentation but is directly associated with a higher risk of death.
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Dates et versions

hal-03595051 , version 1 (03-03-2022)

Identifiants

Citer

Chloé Bost, Eve Chanson, Géraldine Picard, David Meyronet, Marie-Eve Mayeur, et al.. Malignant tumors in autoimmune encephalitis with anti-NMDA receptor antibodies. Journal of Neurology, 2018, 265 (10), pp.2190-2200. ⟨10.1007/s00415-018-8970-0⟩. ⟨hal-03595051⟩

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