TY  -  JOUR
AU  -  Assandri, Roberto
AU  -  Grassini, Angelo
AU  -  Manzoni, Mariangela
AU  -  Padrenostro, Mauro
AU  -  Ferrò, Maria Teresa
T1  -  Anti-CRMP5 paraneoplastic antibodies detection during checkpoint inhibitors therapy: a case report
PY  -  2025
Y1  -  2025-12-01
DO  -  10.1701/4619.46285
JO  -  Recenti Progressi in Medicina
JA  -  Recenti Prog Med
VL  -  116
IS  -  12
SP  -  737
EP  -  741
PB  -  Il Pensiero Scientifico Editore
SN  -  2038-1840
Y2  -  2026/05/21
UR  -  http://dx.doi.org/10.1701/4619.46285
N2  -  Summary. Immune checkpoint inhibitors (ICIs) are anti-neoplastic monoclonal antibodies (Abs), using in advanced malignancies, including small cell lung cancer (SCLC). Impairment of immune tolerance due to ICIs is associated with immune-mediated disorders as paraneoplastic neurological syndromes (PNSs) in 1% of patients. Due to rarity of these cases, clinicians and laboratories should be ready to recognized and characterized the clinical and biochemical features. Here we present a rare case-patient with advanced SCLC treated with checkpoint inhibitors who developed paraneoplastic encephalitis as paraneoplastic neurological disorder. The literature highlights how the identification of clinical and radiological features and the detection of an extended panel of Abs had now become essential for a correct diagnosis. What kind of laboratory assays are necessary to perform the correct diagnosis? Different techniques have been used to detect antibodies associated with paraneoplastic diseases. The combined use of Tissue Based Assay, immunoblot with recombinant antigens and Cell-Based Assay are necessary to individuate the correct diagnosis. This strategy provides the detection of high-risk antibodies (as CRMP5 antibodies) in serum and cerebrospinal fluid (CSF) with crucial impact to correct diagnosis and treatment. In this regard our case report proposes diagnostic flow chart to detect and define paraneoplastic Abs.
ER  -