A case of paraneoplastic optic neuropathy and outer retinitis positive for autoantibodies against collapsin response mediator protein-5, recoverin, and α-enolase

BMC Ophthalmology

Case Report

Susumu Ishida¹  Michiyuki Saito¹  Wataru Saito¹  Atsuhiro Kanda¹  Hiroshi Ohguro² 

[1] Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan;Department of Ophthalmology, Sapporo Medical University School of Medicine, Sapporo, Japan;

关键词: Neuroretinitis;    Recoverin;    Cancer-associated retinopathy;    Collapsin response mediator protein-5;    Outer retinitis;   

DOI  :  10.1186/1471-2415-14-5

 received in 2013-07-02, accepted in 2014-01-14,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundSpecific cross-reacting autoimmunity against recoverin or collapsin response mediator protein (CRMP)-5 is known to cause cancer-associated retinopathy or paraneoplastic optic neuropathy, respectively. We report a rare case with small cell lung carcinoma developing bilateral neuroretinitis and unilateral focal outer retinitis positive for these antibodies.Case presentationA 67-year-old man developed bilateral neuroretinitis and foveal exudation in the right eye. Optical coherence tomography showed a dome-shaped hyperreflective lesion extending from inner nuclear layer to the photoreceptor layer at the fovea in the right eye. Single-flash electroretinography showed normal a-waves in both eyes and slightly reduced b-wave in the left eye. Results of serological screening tests for infection were within normal limits. The patient’s optic disc swelling and macular exudation rapidly improved after oral administration of prednisolone. Systemic screening detected lung small cell carcinoma and systemic chemotherapy was initiated. Immunoblot analyses using the patient’s serum detected autoantibodies against recoverin, CRMP-5, and α-enolase, but not carbonic anhydrase II. Neuroretinitis once resolved after almost remission of carcinoma on imaging but it recurred following the recurrence of carcinoma.ConclusionsThe development of neuroretinitis in this cancer patient with anti-retinal and anti-optic nerve antibodies depended largely on the cancer activity, suggesting the possible involvement of paraneoplastic mechanisms. Patients with paraneoplastic optic neuropathy and retinopathy are likely to develop autoimmune responses against several antigens, thus leading to various ophthalmic involvements.

【 授权许可】

CC BY   
© Saito et al.; licensee BioMed Central Ltd. 2014