Book contents
- Autoimmune Encephalitis and Related Disorders of the Nervous System
- Autoimmune Encephalitis and Related Disorders of the Nervous System
- Copyright page
- Dedication
- Contents
- Clinical Vignettes
- Videos
- Preface
- Abbreviations
- Section 1 Overview
- Section 2 Antibodies and Antigens
- Section 3 Specific Syndromes and Diseases
- Chapter 6 Limbic Encephalitis
- Chapter 7 Autoimmunity Against Proteins Associated with Voltage-Gated Potassium Channels
- Chapter 8 Anti-NMDAR Encephalitis
- Chapter 9 Seizures and Antibodies Against Surface Antigens
- Chapter 10 Acute Disseminated Encephalomyelitis and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease
- Chapter 11 Neuromyelitis Optica Spectrum Disorders and Glial Fibrillary Acidic Protein Autoimmunity
- Chapter 12 Autoimmune Cerebellar Ataxias
- Chapter 13 Autoimmune Brainstem Encephalitis
- Chapter 14 Autoimmunity Against the Inhibitory Synapsis
- Chapter 15 Anti-IgLON5 Disease
- Chapter 16 Autoimmune and Inflammatory Encephalopathies as Complications of Cancer
- Chapter 17 Deconstructing Hashimoto Encephalopathy
- Chapter 18 CNS Syndromes at the Frontier of Autoimmune Encephalitis
- Section 4 Autoimmunity in Neurological and Psychiatric Diseases
- Index
- References
Chapter 16 - Autoimmune and Inflammatory Encephalopathies as Complications of Cancer
from Section 3 - Specific Syndromes and Diseases
Published online by Cambridge University Press: 27 January 2022
- Autoimmune Encephalitis and Related Disorders of the Nervous System
- Autoimmune Encephalitis and Related Disorders of the Nervous System
- Copyright page
- Dedication
- Contents
- Clinical Vignettes
- Videos
- Preface
- Abbreviations
- Section 1 Overview
- Section 2 Antibodies and Antigens
- Section 3 Specific Syndromes and Diseases
- Chapter 6 Limbic Encephalitis
- Chapter 7 Autoimmunity Against Proteins Associated with Voltage-Gated Potassium Channels
- Chapter 8 Anti-NMDAR Encephalitis
- Chapter 9 Seizures and Antibodies Against Surface Antigens
- Chapter 10 Acute Disseminated Encephalomyelitis and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease
- Chapter 11 Neuromyelitis Optica Spectrum Disorders and Glial Fibrillary Acidic Protein Autoimmunity
- Chapter 12 Autoimmune Cerebellar Ataxias
- Chapter 13 Autoimmune Brainstem Encephalitis
- Chapter 14 Autoimmunity Against the Inhibitory Synapsis
- Chapter 15 Anti-IgLON5 Disease
- Chapter 16 Autoimmune and Inflammatory Encephalopathies as Complications of Cancer
- Chapter 17 Deconstructing Hashimoto Encephalopathy
- Chapter 18 CNS Syndromes at the Frontier of Autoimmune Encephalitis
- Section 4 Autoimmunity in Neurological and Psychiatric Diseases
- Index
- References
Summary
In this chapter we review the CNS syndromes mediated by autoimmune or inflammatory mechanisms in patients with cancer. Paraneoplastic neurological syndromes (PNS) are considered to be immune-mediated disorders against proteins expressed by the tumour and nervous system. The autoimmune hypothesis is supported by the presence in serum and CSF of antibodies against neural proteins that are also expressed in the tumour. Less frequently the tumour does not express neuronal proteins but predisposes to immune dysregulation and autoimmune mechanisms. Novel cancer therapies that enhance anti-tumour immune responses frequently cause inflammatory CNS disorders. Immune checkpoint inhibitors have been associated with a wide range of immune-related adverse effects, including an increased incidence of PNS. Another type of cancer therapy is based on the use of T cells genetically engineered to express chimeric antigen receptors (CARs) that recognize molecules present on the surface of tumour cells. CAR T cell therapy can cause severe, potentially lethal, encephalopathy syndromes mediated by massive release of cytokines instead of autoimmune mechanisms. Post-transplant autoimmune encephalitis are rare disorders that mostly occur after allogeneic haematopoietic stem cell transplantation. They are related to graft versus host disease and, sometimes, they associate with antibodies against neuronal surface antigens.
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- Publisher: Cambridge University PressPrint publication year: 2022