Human chorionic gonadotropin treatment of anti-Hu-associated paraneoplastic neurologicalsyndromes
| Autor: | Herbert Hooijkaas, F van Broekhoven, Jacoline E C Bromberg, M. T. de Graaf, N A Khan, Maarten A. Frens, M. J. van den Bent, R Benner, J. W. de Beukelaar, P. A. E. Sillevis Smitt, J.N. van der Geest, Jan-Willem Gratama |
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| Přispěvatelé: | Neurosciences, Neurology, Immunology, Medical Oncology, Radiology & Nuclear Medicine |
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Neurological disorder Chorionic Gonadotropin Injections Intramuscular Autoimmune Diseases Human chorionic gonadotropin Disability Evaluation Mice SDG 3 - Good Health and Well-being Mice Inbred NOD Modified Rankin Scale Internal medicine Activities of Daily Living medicine Animals Humans Prospective Studies Mobility Limitation Prospective cohort study Aged Autoantibodies Neurologic Examination Pregnancy business.industry Multiple sclerosis Middle Aged Th1 Cells medicine.disease Connective tissue disease Surgery Psychiatry and Mental health Rheumatoid arthritis Female Neurology (clinical) business Paraneoplastic Syndromes Nervous System |
| Zdroj: | Journal of Neurology Neurosurgery and Psychiatry, 81(12), 1341-1344. BMJ Publishing Group |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp.2009.177865 |
| Popis: | Objective Paraneoplastic neurological syndromes associated with anti-Hu antibodies (Hu-PNS) are mediated by a T-cell immune response that is directed against the Hu antigens. In pregnancy, many Th1-mediated autoimmune diseases such as rheumatoid arthritis and multiple sclerosis regress. We hypothesised that this decreased disease activity during pregnancy may be related to high human chorionic gonadotropin (hCG) levels. Methods 15 Hu-PNS patients were treated in a prospective, uncontrolled and unblinded trial with 10 000 IU daily of hCG administered by intramuscular injection during 12 weeks. Primary outcome measures were functional improvement defined as a decrease of one or more points on the modified Rankin Scale (mRS) or stabilisation in patients with mRS score = 1 point. Five patients improved on the Barthel Index (33%). Conclusion Comparison with previous studies suggests that hCG may have immunomodulatory activity and may modify the course of Hu-PNS, although well-established confounding factors may have contributed in this uncontrolled trial. |
| Databáze: | OpenAIRE |
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