Sensory ganglionopathy and dysautonomia in small cell lung cancer

초록

Abstract A 54-year-old previously healthy male smoker was hospitalized due to a tingling sensation in theupper and lower extremities. He complained that walking became difficult due to loss of balance and numbness and was admitted under the impression of CIDP. Brain and spine MRI examinations and needle electromyography (EMG) were unspecific, but a nerve conduction study (NCS) revealed length-dependent-pattern sensory dominant polyneuropathy. A CSF study showed no specific findings for cell numbers, proteins, or immune tests. Due to complaints of progressive dizziness when standing after hospitalization, he was initially diagnosed with orthostatic hypotension. However, his anti-Hu autoantibody test was positive, and chest CT and PET revealed a left inter-lobar lymph node mass with enhancement suggestive of lung cancer. Endoscopic biopsy confirmed small cell lung cancer (SCLC). The chemo-radiation treatment for SCLC and immunoglobulin therapy for sensory ganglionopathy were performed. In this case, we definitively diagnosed paraneoplastic neurologic syndrome. Although rare, our observations suggest symptoms of dysautonomia and sensory ganglionopathy might be related to the production of anti-Hu antibody.