Paraneoplastic Autonomic Disorders: Neurological Autoimmunity and Implications
Delve into the concept and pathophysiology of paraneoplastic neurological disorders, with a focus on autonomic issues that are often underrecognized. Learn about the clinical presentations, autoimmune implications, and the role of neuroantibody testing in diagnosis. Explore how these disorders can manifest in the context of cancer and immune checkpoint inhibitor therapy. References to recent studies and reviews provide a comprehensive overview of this complex topic.
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Presentation Transcript
Paraneoplastic Autonomic Disorders Steven Vernino MD PhD FAAN FAAS Professor of Neurology, UT Southwestern Rex Griswold Distinguished Professor in Multiple System Atrophy Dr. Bob and Jean Smith Foundation Distinguished Chair in Neuromuscular Disease Research Past president, American Autonomic Society
Disclosures Dr. Vernino has served as consultant for argenx, Alterity, Antag, LabCorp, CSL Behring Research support from NIH, Dysautonomia International, Sjogren s Foundation, Grifols, Takeda, BioHaven and Quest/Athena Diagnostics
Learning Objectives Review the concept and pathophysiology of Paraneoplastic neurological disorders Recognize the clinical presentations of Paraneoplastic autonomic disorders Understand the implication of neurological autoantibody results Be aware of other autoimmune/paraneoplastic disorders with autonomic features
Summary Neurological autoimmunity may occur in the context of cancer and may be precipitated by immune checkpoint inhibitor therapy Autonomic disorders (especially GI dysmotility) are common paraneoplastic neurological syndromes Paraneoplastic autonomic issues may be underrecognized Autoantibody testing can assist with diagnosis
References Blackburn KM, Kubiliun M, Harris S, Vernino S. Neurological autoimmune disorders with prominent gastrointestinal manifestations: A review of presentation, evaluation, and treatment. Neurogastroenterol Motil. 2019;31(10):e13611. Lucchinetti CF, Kimmel DW, Lennon VA. Paraneoplastic and oncologic profiles of patients seropositive for type 1 antineuronal nuclear autoantibodies. Neurology. 1998;50(3):652-657. Vernino S. Autoimmune Autonomic Disorders. Continuum (Minneap Minn). 2020;26(1):44-57. Darnell RB, Posner JB. Paraneoplastic syndromes involving the nervous system. N Engl J Med. 2003;349(16):1543-1554.
