Paraneoplastic neurological syndromes - patients' cohort profile in the Czech Republic

Reported paraneoplastic neurological syndromes (PNS) are rare disabling neu rological diseases with supposed autoimmune pathogenesis. The aims of this study were to evaluate frequency, clinical course and therapeutic response in the cohort of PNS positive patients (n = 10) in the Czech Republic for t he first time. Second, we determined the presence and distribution of oligo clonal. IgG bands (OB IgG) in PNS and compared the clinical and laboratory features of OB IgG positive and negative patients. A total of 2355 suspicio us serum and/or CSF samples were screened by immunofluorescence and immunoh istochemistry with definite confirmation by Western blot. OB IgG were detec ted by isoelectric focusing and immunoenzymatic staining and clinical statu s was scored according to modified Rankin scale (RS). Four patients had ant i-Yo antibody, ovarian cancer and the score in range (2-5) on RS. Five pati ents had anti-Hu antibody, small cell lung cancer (SCLC), prostate cancer a nd the score between 1-4 grade on RS. One patient with SCLC and anti-Ri ant ibody had grade 2. Five of 10 patients with PNS had positive OB IgG and ave rage value 4.2 on RS comparing with negative OB IgG patients with average v alue 2.6. Finally, we add well-defined cohort of PNS patients to emerging E uropean profile of PNS and conclude that the presence of OB IgG in PNS seem s to reflect enhanced immune response with more severe neurological damage and clinical course.