Abstract Details

Title Spectrum of Neuroradiological Findings in Novel High-risk Paraneoplastic Syndromes

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-017

Objective

To systematically review neuroradiological findings in patients positive for novel high-risk paraneoplastic antibodies - LUZP4-IgG, KLHL11, TRIM46, and PDE10A IgG.

Background

Paraneoplastic neurological syndromes (PNS) demonstrate characteristic antibodies and imaging patterns reflecting the areas of immune-mediated damage. Recent studies have identified novel high-risk antibodies linked to distinct imaging findings that can facilitate recognition of these rare syndromes.

Design/Methods A systematic literature review was conducted for studies published between 2014-2023 reporting neuroimaging findings in patients with high-risk paraneoplastic antibodies. PubMed and Embase were searched, identifying 379 articles. After screening, 96 patients positive for the novel high-risk antibodies were included in the final analysis. Data was extracted on antibody subtype, associated tumor, clinical phenotype, and neuroradiological findings.

Results The review comprised 22 TRIM46, 40 PDE10A, 6 LUZP4, and 28 KLHL11-positive patients. Rhombencephalitis predominated in 61% of LUZP4 and 44% of KLHL11 cases. Cerebellar atrophy occurred in 64% of TRIM46 and 69% of KLHL11 cases. Temporal lobe/limbic abnormalities were seen in 22% of KLHL11 cases. Basal ganglia lesions typified 40% of PDE10A cases. High-risk antibodies associated with deep brain lesions, younger male patients, and 61% mortality.

Conclusions Specific neuroimaging patterns associate with these novel antibodies. Recognizing the distinctive radiological findings could enable timely PNS diagnosis and tumor detection. Further research on sensitivity, specificity, and testing algorithms is warranted. Appropriate neuroimaging is crucial to avoid delayed or missed PNS diagnoses.

Authors/Disclosures
Mahmoud Elkhooly, MD PRESENTER	Dr. Elkhooly has nothing to disclose.
Sema Akkus, MD (Mount Sinai West)	Dr. Akkus has nothing to disclose.
Suban Amatya	Suban Amatya has nothing to disclose.
Kriti Shrestha	Kriti Shrestha has nothing to disclose.
Yusuf Kagzi	Mr. Kagzi has nothing to disclose.
Shitiz K. Sriwastava, MBBS (UT Health Houston)	Dr. Sriwastava has nothing to disclose.

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