Table 1.
Clinical characteristics of 49 patients with PND and Zic4 antibodies
| Immunity | Anti-Zic4, 9 patients | Anti-Zic4 and anti-Hu and/or anti-CRMP5 antibodies, 40 patients |
|---|---|---|
| Median age (range), y | 67 (59–85) | 66 (4.5–85) |
| Male, n | 8 | 19 |
| Predominant syndrome at diagnosis, n | ||
| Cerebellar (p < 0.001)* | 8 (1 with LEMS) | 10 (1 with LEMS) |
| Sensory neuropathy | — | 9 |
| Limbic encephalitis | — | 3 |
| Brainstem | — | 1 |
| Sensorimotor neuropathy | — | 2 |
| Orthostatic hypotension | — | 1 |
| Multifocal | 1 (with LEMS) | 14† (3 with LEMS) |
| Development of PND, n (mo) | ||
| Before tumor diagnosis | 5 (1–10, median 3) | 26 (2–26, median 3) |
| At tumor diagnosis | 1 | 6 |
| After tumor diagnosis | 2 (3 and 3) | 8 (2–48, median 4) |
| Tumor type, n | ||
| Small-cell lung cancer | 8 | 36 |
| Other | — | 4‡ |
| No tumor | 1§ | — |
| Limited tumor stage at diagnosis, n | 6/7 | 30/35 |
*
Chi-square with Yates’ correction.
†
Eleven of these patients had symptoms of cerebellar dysfunction along with other prominent symptoms associated with the following: brainstem encephalopathy (6), sensory neuronopathy (5), short-term memory deficits (3), seizures (4), myelopathy (2), orthostatic hypotension (1).
‡
One patient had adenocarcinoma of the lung with anti-Hu antibodies, 1 neuroblastoma, 1 a Merkel cell carcinoma, and 1 radiologic evidence of a lung tumor.
§
Mediastinal adenopathy but biopsy negative for tumor.
PND = paraneoplastic neurologic disorders; LEMS = Lambert-Eaton myasthenic syndrome.