A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer

Raymond Voltz, Sakir Gultekin, Myrna R. Rosenfeld, Elizabeth Gerstner, Joseph Eichen, Jerome B. Posner, Josep Dalmau

Research output: Contribution to journalArticle

278 Citations (Scopus)

Abstract

Background: In patients with cancer, symptoms of limbic and brain-stem dysfunction may result from a paraneoplastic disorder. Paraneoplastic limbic or brainstem encephalitis occurs more frequently with testicular cancer than with most other cancers. We sought antineuronal antibodies that might be used in a diagnostic test for this syndrome. Methods: Immunohistochemical and immunoblotting techniques were used to detect serum and cerebrospinal fluid antibodies. Serologic screening of a complementary DNA library and Northern blotting were used to clone the target antigen and determine which tissues expressed it. Results: Of 13 patients with testicular cancer and paraneoplastic limbic or brain-stem encephalitis (or both), 10 had antibodies in serum and cerebrospinal fluid against a 40-kd neuronal protein. These antibodies were used to clone a gene that we call Ma2, which codes for a protein (Ma2) that was recognized by serum from the 10 patients, but not by serum from 344 control subjects. Ma2 was selectively expressed by normal brain tissue and by the testicular tumors of the patients. Ma2 shares homology with Ma1, a 'brain-testis-cancer' gene related to other paraneoplastic syndromes and tumors. Conclusions: The serum of patients with subacute limbic and brain-stem dysfunction and testicular cancer contains antibodies against a protein found in normal brain and in testicular tumors. Detection of these antibodies supports the paraneoplastic origin of the neurologic disorder and could be of diagnostic importance.

Original languageEnglish (US)
Pages (from-to)1788-1795
Number of pages8
JournalNew England Journal of Medicine
Volume340
Issue number23
DOIs
StatePublished - Jun 10 1999
Externally publishedYes

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Testicular Neoplasms
Encephalitis
Brain Stem
Antibodies
Serum
Cerebrospinal Fluid
Clone Cells
Paraneoplastic Syndromes
Neoplasms
Proteins
Neoplasm Genes
Brain
Nervous System Diseases
Gene Library
Immunoblotting
Routine Diagnostic Tests
Brain Neoplasms
Northern Blotting
Complementary DNA
Antigens

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Voltz, R., Gultekin, S., Rosenfeld, M. R., Gerstner, E., Eichen, J., Posner, J. B., & Dalmau, J. (1999). A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer. New England Journal of Medicine, 340(23), 1788-1795. https://doi.org/10.1056/NEJM199906103402303

A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer. / Voltz, Raymond; Gultekin, Sakir; Rosenfeld, Myrna R.; Gerstner, Elizabeth; Eichen, Joseph; Posner, Jerome B.; Dalmau, Josep.

In: New England Journal of Medicine, Vol. 340, No. 23, 10.06.1999, p. 1788-1795.

Research output: Contribution to journalArticle

Voltz, R, Gultekin, S, Rosenfeld, MR, Gerstner, E, Eichen, J, Posner, JB & Dalmau, J 1999, 'A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer', New England Journal of Medicine, vol. 340, no. 23, pp. 1788-1795. https://doi.org/10.1056/NEJM199906103402303
Voltz, Raymond ; Gultekin, Sakir ; Rosenfeld, Myrna R. ; Gerstner, Elizabeth ; Eichen, Joseph ; Posner, Jerome B. ; Dalmau, Josep. / A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer. In: New England Journal of Medicine. 1999 ; Vol. 340, No. 23. pp. 1788-1795.
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