Isolated paraneoplastic optic neuropathy associated with acute lymphoblastic leukemia and collapsin response-mediating protein (CRMP-5) autoantibody

Tzu Lun Huang, Ruey Ho Kao, Yih Chun Lin, Rong Kung Tsai

研究成果: 雜誌貢獻文章

摘要

We present a patient with leukemia associated with a CRMP-5-related paraneoplastic optic neuropathy (PON). A 30-year-old man with acute lymphoblastic leukemia (ALL) and complete chemotherapy suffered from a subacute painless visual loss in both eyes. His vision progressively decreased to 20/300 (OD) and 20/2000 (OS), respectively. Fundoscopy showed a massive disc edema (OS). Autoperimetry demonstrated generalized depression in both eyes. Magnetic resonance imaging (MRI) revealed swelling of left optic nerve at the orbital apex. Lumbar puncture examinations revealed a normal intracranial pressure and without tumor cell infiltration. CSF and serum for autoantibody examinations by using western blot showed a positive reaction to CRMP-5, but negative in myelin, voltage-dependent calcium channel alpha 1 (CACNA1), enolase and recoverin. Repeated lumbar puncture revealed a few immature myelomonocytic cells in CSF. Intravenous pulse therapy with Solu-Medrol associated with chemotherapy was administrated, the vision recovered to 20/40 (OD) and 20/60 (OS) within three days. One month later, his vision recovered to 20/20 (OD) and 20/30 (OS), as well as disc edema in left eye completely resolved. Paraneoplastic optic neuropathy should be in the differential considerations of disc edema in patients with malignancy.
原文英語
頁(從 - 到)337-343
頁數7
期刊Neuro-Ophthalmology Japan
27
發行號3
出版狀態已發佈 - 九月 1 2010
對外發佈Yes

指紋

Paraneoplastic Polyneuropathy
Semaphorin-3A
Optic Nerve Diseases
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Autoantibodies
Edema
Spinal Puncture
Recoverin
Methylprednisolone Hemisuccinate
Drug Therapy
Proteins
Phosphopyruvate Hydratase
Intracranial Pressure
Calcium Channels
Optic Nerve
Myelin Sheath
Neoplasms
Leukemia
Western Blotting
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology

引用此文

Isolated paraneoplastic optic neuropathy associated with acute lymphoblastic leukemia and collapsin response-mediating protein (CRMP-5) autoantibody. / Huang, Tzu Lun; Kao, Ruey Ho; Lin, Yih Chun; Tsai, Rong Kung.

於: Neuro-Ophthalmology Japan, 卷 27, 編號 3, 01.09.2010, p. 337-343.

研究成果: 雜誌貢獻文章

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