PT  - JOURNAL ARTICLE
AU  - Castle, George
AU  - Heath, Greg
TI  - Small cell carcinoma presenting as ocular paraneoplastic syndrome due to CRMP-5
AID  - 10.17712/nsj.2020.5.20200095
DP  - 2020 Oct 01
TA  - Neurosciences Journal
PG  - 403--405
VI  - 25
IP  - 5
4099  - http://nsj.org.sa/content/25/5/403.short
4100  - http://nsj.org.sa/content/25/5/403.full
SO  - Neurosciences (Riyadh)2020 Oct 01; 25
AB  - We report the case of a lady who presented with 3 weeks of visual floaters and optic disc swelling. Subsequent investigations revealed deep white matter changes on brain imaging, and enlarged mediastinal nodes. The presence of anti-CRMP-5 antibodies finally led to the diagnosis of a paraneoplastic syndrome, and mediastinal lymph node biopsy confirmed the diagnosis of small-cell lung cancer. The learning points from this case include that optic neuritis can be the only presenting feature of a paraneoplastic neurological syndrome, and the usefulness of anti-neuronal antibody measurement as a diagnostic marker of an underlying paraneoplastic disease process. The great challenge is to recognise these tumour-associated autoimmune system presentations early, as they often appear long before the primary cancer is evident. Prompt treatment leads to an earlier reduction in circulating auto-antibody possibly due to reduction in tumour size, and thus less likelihood of permanent neuronal damage.